OrthoPets Blog

OrthoPets Patient Feature: Morgan

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Meet Morgan! Morgan is a shepherd mix pup who received her below tarsus prosthetic device through Dr. Kern at our fantastic Michigan Partner Clinic, Pawsitive Steps Rehabilitation. Morgan’s initial consult was at only 10 weeks of age, not long after she was adopted by a pair of veterinarians. Morgan was born without her distal left hind limb, below her tarsus. She would to try to walk on her stump when moving slowly, but would hold it up and hop on three legs when she wanted to go faster. Sometimes, she had a hard time getting traction with her stump, which was challenging for her. She would also to extend the tarsus/hock joint of that limb very straight, possibly in an effort to “reach” for the ground with the stump. 

Everyone agreed that Morgan would be a great candidate for a prosthesis, but because of her young age and likelihood of needing multiple devices as she outgrew them, her owners opted to wait to start the prosthetic process until Morgan was closer to full grown. In the meantime, Morgan did a lot of rehabilitation at Pawsitive Steps to work on improving her core strength, balance and especially focused on flexing the tarsal joint of her residual limb. It was also very important to get her comfortable with that limb being handled to prepare her for donning and doffing of the device. 

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When Morgan was close to full grown, Dr. Kern did her fiberglass impression and measurements for her prosthetic device. Because of the amount of limb remaining, Morgan was borderline between making a prosthetic with a non-articulating tarsus (no motion) and an articulating one (motion allowed). Since Morgan is young and preserving as much range of motion in her tarsal joint as possible was priority, Dr. Kern and Silver (Morgan’s OrthoPets Case Manager) decided on the articulating version, with motion limiting straps available in case Morgan did not handle the articulation well. 

Morgan received her device in August of 2016. Her device not only helps protect her stump and gives her good traction, but makes up the limb length discrepancy she has so that her hips can be level and her spine can stay neutral, which is very important for long-term health and comfort. Slow acclimation to the device is important to ensure the patient is using the device properly. Otherwise, they may form “bad habits” such as lifting their prosthetic limb during faster gaits, improper sitting, etc. Rehabilitation and supervised, structured, slow and steady work upon receipt of a device is important so that patients can learn good habits and become accustomed to using the device as if their prosthetic limb had been there the entire time and eventually they can tear around and play. 

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Great job, Morgan and family! We love your pirate style!

 

OrthoPets March 2017 Case Study for the Canine Rehabilitation Institute

When 10 months old, Bianca was rescued in Italy after she had become stuck in an illegal trap. It was estimated she had been in the trap for 3 days causing such severe damage to her hindlimbs that sub-total amputations proximal to the tarsi were necessary. The rescue began working with our OrthoPets Europe Distributor to provide prosthetic devices to her.
Current recommendations for a functional outcome with prosthetics with our devices include the following: Patients must have a functional stifle as well as at least 40% of the tibia/fibula remaining. Retaining the tarsus is ideal for a prosthesis to aid in suspension, however it is not always plausible for our patients as seen in Bianca. Due to her amputation levels, she was not a candidate for our standard prosthetic design. Patients with amputation levels proximal to the tarsi may be candidates for a specialized prosthesis called a “Chevy” Prosthesis, named after the first patient this design was fabricated for. While we highly recommend each of our devices be accompanied by a formal rehabilitation program, it is definitely required for Chevy Prosthetic patients. These patients will have an extensive learning curve and will need at least 1 year of rehabilitation to provide them the best opportunity to be fully functional in the device.
Bianca received bilateral “Chevy” prostheses which are connected together by a pelvic plate. The “Chevy” design provides a prosthetic solution for patients who otherwise may require a full limb amputation and/or wheelchair.
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Bianca has been doing exceptionally well! Here is a video of Bianca 11 days after her initial fitting: Bianca: 11 Days Post Initial Prosthetic Fitting

OrthoPets is currently working with Colorado State University to determine outcomes in patients with partial limb amputations and the use of a prosthesis. Here is a link to more information regarding this study: Clinical Trial: Evaluation of Partial Amputation in Dogs.
OrthoPets February 2017 Case Study for the Canine Rehabilitation Institute

OrthoPets February 2017 Case Study for the Canine Rehabilitation Institute

 

4c0318c8-4bd3-4c56-9548-1a7b567ab3fa.jpgGibson is a 5-year-old MC Border Collie that lives in Mexico. His veterinarian is Dr. Gabriel Ramirez who has a long working relationship with OrthoPets. Dr. Ramirez frequently sees cases that have had complications elsewhere and is known to “think outside of the box” with the goal to his patients to gain their mobility back as quickly as possible. In Gibson’s case, he had a pancarpal arthrodesis. Unfortunately, the post-operative bandage was placed too tightly and caused tissue necrosis. The medical team tried to save the limb but eventually the “only” established option for him was a full-limb amputation. However, since the affected area was distal on the limb, the owner elected a sub-total amputation and prosthetic.

OrthoPets is currently gathering retrospective and prospective data on canine prosthetics, however, based on our current experience a few things are important when considering a prosthetic device: Prosthetic candidates should be amenable to handling of the residual limb and a long enough limb to allow appropriate suspension of the device and proprioception to properly use the device in a functional manner is necessary.

The combination of these two factors will translate into the functionality of the device and ultimately serve as a predictor for the success of the case. The total length of residuum is currently unknown, and it varies depending on the anatomy of the remaining limb. For example, we have some cases that show appropriate suspension with a mid-radius amputation while others don’t have prominent enough humeral epicondyles to allow successful suspension. In general, the more distal the better the chances to have a successful outcome. As such, Gibson is a perfect case for this treatment.

Regarding the surgical approach to a sub-total amputation with the goal of utilizing a prosthesis, it is important to consider the following:

  • Skin suture line location to avoid scar tissue formation on the weight bearing surface of the limb
  • Remaining soft tissue placement to encourage comfortable weight bearing
  • Identification of nerves to avoid placement over the residuum

Gibson’s amputation was performed so that the accessory carpal bone remained which created a bulbous distal end aiding with the suspension. The device was fabricated with a removable liner for replacements to be sent as needed rather than requiring the device to be sent to us. A traditional style prosthesis has a “fixed” liner that is connected to the shell requiring the entire device and additional steps to replace or change the liner. The removable liner approach allows us to replace, duplicate and adjust the foam liner without needing the entire device.

Gibson was fit with his prosthesis and immediately took very well to it! So far, Gibson’s device has not needed any adjustments aside from tread replacement which can easily be done by his owner. The entire team at OrthoPets as well as his medical team was pleased with the fit of the device and how quickly Gibson adapted to his old activities such as playing with a Frisbee. Gibson will need regular rechecks to ensure that the device is not only fitting well but that the device is still providing appropriate function to his affected limb.

For additional information: Colorado State University is conducting an ongoing study evaluating partial amputation in dogs. Read more here.

February 2017 Email News from the Canine Rehabilitation Institute

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In Our February 2017 Issue …30c722bb-283c-4504-8145-c47be6575c9c.jpg

  • Register Now for Spring Courses in Germany!
  • We’ve Certified Our 1,000th Graduate!
  • Our April Therapist Course Has Seats Available … and Registration Is Open for June Courses in Colorado!
  • Discounted Hotel Rates Are Now Available for Courses in Wheat Ridge, Colorado
  • Thank You for Your Feedback on Our CE Courses … and more!

 

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Register Now for Our Spring Courses in Germany! 6d6fe415-cf81-4ccb-b4d3-406167ac88ef.jpg

CRI is excited to return to Frankfurt, Germany this spring for two courses in our certification program. 

Our two courses will be:

  • May 26-28: Canine Sports Medicine
  • May 30-June 3: Introduction to Canine Rehabilitation
Both courses will once again be held at Tierärztliches Orthopädie Team Frankfurt (formerly known as Praxis für Tiermedizin & Chiropraktik) at its newly renovated facility in Frankfurt, Germany. 
 
Visit our German Program page for more details about both courses and a link to register. Register now to reserve your space!

ed74b962-d6bf-466a-855d-37bb468dbccc.jpgTime to Celebrate! We’ve Certified Our 1,000th Graduate!

We knew this milestone was coming soon, and now it’s official! We certified our 1,000th graduate in January! To celebrate, we’re featuring our 1,000th graduate in an upcoming email and sending a few surprises his or her way. Stay tuned for more details coming soon!


Our April Therapist Course in Florida Has a Few Seats Available … and Registration Is Open for June Courses in Colorado!8a764119-01ab-4218-9d93-db8e1b52252b.jpg

A few seats have opened up in our April Canine Rehabilitation Therapist course, coming up in Coral Springs, Florida. If you have been meaning to complete your certification, this is a great opportunity to move forward and enjoy a spring getaway in Florida!

We also have opened registration for our June Introduction to Canine Rehabilitation and Canine Sports Medicine courses at our brand-new facility in Wheat Ridge, Colorado.

Register today, and reserve your seat!

Registration is currently open for the following U.S. and international classes:

Please check our website for the most up-to-date course schedule.

Remember that we also offer discounted 2-course packages for either (1) The Canine Rehabilitation Therapist plus Canine Sports Medicine or (2) The Canine Rehabilitation Assistant plus Canine Sports Medicine. Please see the 2-Course Packages section at the bottom of the Online Registration page for more details. If you are not sure when you plan to take a course, you may choose the option of a “Future” class. “Future” registrations may be subject to tuition increases. (Learn more.)

If you have previously registered for a “Future” course and wish to attend a 2017 class that is now open for registration, be sure to contact CRI and tell us which course you would like to attend. This is the only way to guarantee you have a seat in the course.

Don’t wait – register today to reserve your seat!


Save the Dates for June-December Courses! 85704c66-3fc4-4e58-93bb-11664df995db

Planning to take CRI courses later this year? We’ve added June-December courses to the Course Schedule page on the CRI website, so you can get these dates on your calendar and reserve time to attend.

Our summer and fall courses will take place at Wheat Ridge Animal Hospital‘s brand-new facility in Wheat Ridge, Colorado, just west of Denver (see article below). Construction is on track to wrap up in April, so we will be among the first to enjoy this beautiful new space!

Please check the Course Schedule page on our website, and save the dates for the courses you wish to take. Be sure to watch this newsletter for announcements of course openings.


Discounted Hotel Rates Are Now Available for Courses in Wheat Ridge, Colorado.

975f5a53-5be6-4e90-ae92-57c444b11b2fCRI has arranged discounted group rates at the Holiday Inn Express & Suites Wheat Ridge-Denver West for students attending classes at the brand-new Wheat Ridge Animal Hospital in Wheat Ridge, Colorado, located just west of Denver. The hotel is located just a half mile from the new hospital and offers a complimentary full breakfast buffet and free high-speed internet.

Please visit the Wheat Ridge Travel page on our website for more details and reservation codes. We were not able to reserve a block of rooms for our June courses because of a local sports tournament, so we encourage students attending those courses to book rooms individually ASAP.

Wheat Ridge Animal Hospital’s new facility will include a state-of-the-art rehabilitation center and conference facilities. Construction is on schedule and expected to be complete by spring 2017. The staff at CRI is excited about this new opportunity to partner with the team at Wheat Ridge and its parent company, Ethos Veterinary Health.

To follow the progress on the new building, see the construction photos posted in the NEW Wheat Ridge Animal Hospital album on Facebook.

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Left: A pop of color in our surgery prep area. Right: Patient wards now have cabinets. Photos: Steve Hostetler Photography


Thank You for Your Feedback on Our CE Courses!

3c886e91-52c4-4208-99a7-a1228baa8be3.jpgWow! We received a great response to our survey asking for input on our Geriatrics, Nutrition and Pain Management courses. Thank you! Your suggestions are extremely helpful.

Registration will open in March for these three courses, scheduled for August 11-13 at Wheat Ridge Animal Hospital in Wheat Ridge, Colorado. If you completed the survey and asked for advance notice about registering for these classes, please watch for an email coming soon.

Our plans for upcoming CE courses are:

August 11-13, 2017, Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (outside Denver)

In the next 12-18 months:

Two new courses that we’ve had a lot of inquiries about:

  • Canine Massage
  • Advanced Canine Sports Medicine

Which classes are you most interested in, and which dates and locations do you prefer? Please let us know by emailing us at info@caninerehabinstitute.com. We will look at the responses before making final plans.

If you would like to attend our upcoming CE courses, please be sure to read future newsletters for the announcement of course openings.


 

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Students and faculty from the January Therapist class in Australia gather for a group photo.

“You Will Show Others What is Possible for Animals Recovering from Injury or Operation or Degeneration.”

Our January Canine Rehabilitation Therapist course in Australia was a great success! At the end of the course, our Australian host, Dr. Ilana Mendels of VetPrac, asked us to read a note she had written to the students. We would like to share her heartfelt words with the wider CRI community.

Dear Friends,

It was so lovely to see you all last night at dinner. My apologies for not being able to speak to each of you individually. Over the years, of our meetings – I feel grateful to consider so many of you more than colleagues now. It was great to see everyone relaxed and laughing together last night.

I just wanted to say a quick word or two about what this course and you have meant to me and the veterinary community of Australia and to thank you for the investment you have made for a better future of it.

It’s not easy being a trailblazer. There are always challenges. But I truly believe that the greater the challenge the greater the reward. I think we can all agree that this 3 module course is easily the hardest, most intensive workshop VetPrac has every offered. Not everyone who started out in February last year is here now. It’s a tough slog. But you have almost done it. You have taken the fire of a new idea we had and lit for yourselves and this region new opportunities. Thank you.

You are almost qualified as leaders of a new field opening up in our country.
You are the people who will show others what is possible for animals recovering from injury or operation or degeneration.

Less than 5 other people in this country will have your certification.

 

Continue reading Dr. Mendels’ letter on the Australian Program page of our website.

Interested in attending further courses with CRI in Australia?  Please contact us at info@caninerehabinstitute.com.


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CRI students Dr. Susan Hill, Dr. Yoko Clinch, and Dr. Jodie Low Choy tracked down and actual rabbit hole.

In the Words of Our Students … 

Our Aussie students loved CRI faculty member Sasha Foster’s use of the term “rabbit hole” when describing how one could get distracted while working up a patient. Several students tracked down an actual rabbit hole and sent us this wonderful photo and email:

“We found the rabbit hole!

Thank you for the course, thank you for equipping us with skills we hope to grow and take to new heights in Australia. We have all enjoyed your teachings more than you can know.”

Kind regards, 

Susan, Yoko, and Jodie”

 


Registration Is Open for Canine Sports Medicine in the UK in September!0384fdbc-8290-499f-b45c-8dd515f3633b

The Canine Rehabilitation Institute is excited to be returning to the United Kingdom! We will be presenting our Canine Sports Medicine course September 2-4, 2017, at the University of Surrey’s new School of Veterinary Medicine. This brand-new veterinary school has amazing state-of-the-art facilities all in a beautiful park-like setting with hotels nearby in Guildford.

Visit our UK Program page for complete details and a registration link.

We plan to continue with the two remaining courses in our certification program – Introduction to Canine Rehabilitation and The Canine Rehabilitation Therapist – assuming we have sufficient demand. For more details, please see the UK Program page on our website.

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The Canine Sports Medicine course will be held at the University of Surrey’s brand-new School of Veterinary Medicine.

 


We Had a Great Time at NAVC and APTA’s Combined Sections Meeting!

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CRI was again very well received as an exhibitor at two conferences in February – the NAVC Conference in Orlando, Florida, and APTA’s Combined Sections Meeting in San Antonio, Texas.

APTA’s Combined Sections Meeting has 12,000 attendees and hosts all of the APTA’s specialty groups, including the Orthopedics Section, which is the parent organization to the Animal Rehabilitation Special Interest Group (ARSIG). Our own Kirk Peck, DPT, CCRT, CERT, is the president of the ARSIG, and on February 16 hosted a full-day scientific session on canine rehabilitation that had well over 200 attendees. This sent many people to the exhibit hall to learn more about the opportunities for physical therapists to work with veterinarians.

 


Physical Therapists: We Need Your Input for the ARSIG Practice Analysis Survey.

5f74f594-6bae-4e18-abd4-dc39997fc289.jpg Are you a physical therapist working with animals or a veterinarian who has a PT available for consultations? If so, CRI is asking you to help the Animal Rehabilitation Special Interest Group by completing its Practice Analysis survey. Thank you in advance!
Your Input Is Vital!

Welcome to the New Year! If resolutions actually do come true then 2017 looks bright for the Animal Rehabilitation SIG. As you know from past communications a key strategic goal for the SIG is to develop a comprehensive “Description of Practice” for PTs and PTAs who treat animals.  To accomplish this goal the SIG needs your input by completing the survey tool linked below.

Data will be analyzed in aggregate, and summarized into a comprehensive narrative describing PT practice on animals. The summary document may serve various purposes, including validation of animal rehabilitation by PTs and PTAs, legislative support to advance PT scope of practice, and development of curriculum content for educational programs.

The practice analysis survey was developed over a two-year period by an ARSIG Task Force consisting of elected officers and past SIG leaders. Task Force members included: Kirk Peck, Stevan Allen, Amie Hesbach, Carrie Adrian, Cheryl Riegger-Krugh, Lisa Bedenbaugh, and Charlie Evans.

The survey requires approximately 60-90 minutes to complete. You may leave and return to the list of questions at any point in time, but after you click the submit button all responses become final and no longer available for edits.

The goal for total number of completed surveys is at least 100! Please help contribute to making that goal a reality. Your support in growth of the ARSIG is invaluable.

Sincerely,

Kirk Peck PT, PhD, CSCS, CCRT, CERP
President, Animal Rehabilitation SIG
kpeck@creighton.edu
402.280.5633


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CRI Graduates: Request Your Certificates!  

CRI graduates: If you have finished your CCRT or CCRA certification, we would like to send you your certificate! If you have not yet submitted a certificate application, please be sure to do so. We have sent emails to a number of students, but have not received some responses. To request your certificate, please email Kathy Coffman at kathy@caninerehabinstitute.com.

Interested in Some Expert Advice for Your Practice?

Plans are in the works to offer a practice-consulting service to CRI students and graduates, led by CRI founder and CEO Dr. Janet Van Dyke and CRI faculty member Dr. Steve Steinberg who teaches The Business of Canine Rehabilitation. More details will be available in the months ahead. If you are interested, please email us at info@caninerehabinstitute.com.

Be Careful With Protected Terms Such as “Physical Therapy” and “Veterinary Medicine.” 

CRI students and graduates, please remember that you may only use protected terms such as “physical therapy” and “veterinary medicine” in your advertising materials if you are licensed in these fields. We discuss protected terms during Introduction to Canine Rehabilitation, and we hope everyone continues to remember and follow the recommendations provided.

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CRI Graduates: Is Your Contact Information Still Correct?

If you are a CRI graduate, please check your listing in the Find a Therapist online directory and make sure the contact information is correct. If you have any updates, please email Joyce Rudzitis, CRI’s chief operating officer.

OrthoPets Case Study: Gibson

We’ve asked our colleagues at OrthoPets to share case studies with us as a way of providing more education about orthotics and prosthetics.

4c0318c8-4bd3-4c56-9548-1a7b567ab3fa.jpgGibson is a 5-year-old MC Border Collie that lives in Mexico. His veterinarian is Dr. Gabriel Ramirez who has a long working relationship with OrthoPets. Dr. Ramirez frequently sees cases that have had complications elsewhere and is known to “think outside of the box” with the goal to his patients to gain their mobility back as quickly as possible. In Gibson’s case, he had a pancarpal arthrodesis. Unfortunately, the post-operative bandage was placed too tightly and caused tissue necrosis. The medical team tried to save the limb but eventually the “only” established option for him was a full-limb amputation. However, since the affected area was distal on the limb, the owner elected a sub-total amputation and prosthetic.

OrthoPets is currently gathering retrospective and prospective data on canine prosthetics, however, based on our current experience a few things are important when considering a prosthetic device: Prosthetic candidates should be amenable to handling of the residual limb and a long enough limb to allow appropriate suspension of the device and proprioception to properly use the device in a functional manner is necessary.

The combination of these two factors will translate into the functionality of the device and ultimately serve as a predictor for the success of the case. The total length of residuum is currently unknown, and it varies depending on the anatomy of the remaining limb. For example, we have some cases that show appropriate suspension with a mid-radius amputation while others don’t have prominent enough humeral epicondyles to allow successful suspension. In general, the more distal the better the chances to have a successful outcome. As such, Gibson is a perfect case for this treatment.

Regarding the surgical approach to a sub-total amputation with the goal of utilizing a prosthesis, it is important to consider the following:

  • Skin suture line location to avoid scar tissue formation on the weight bearing surface of the limb
  • Remaining soft tissue placement to encourage comfortable weight bearing
  • Identification of nerves to avoid placement over the residuum

Gibson’s amputation was performed so that the accessory carpal bone remained which created a bulbous distal end aiding with the suspension. The device was fabricated with a removable liner for replacements to be sent as needed rather than requiring the device to be sent to us. A traditional style prosthesis has a “fixed” liner that is connected to the shell requiring the entire device and additional steps to replace or change the liner. The removable liner approach allows us to replace, duplicate and adjust the foam liner without needing the entire device.

Gibson was fit with his prosthesis and immediately took very well to it! So far, Gibson’s device has not needed any adjustments aside from tread replacement which can easily be done by his owner. The entire team at OrthoPets as well as his medical team was pleased with the fit of the device and how quickly Gibson adapted to his old activities such as playing with a Frisbee. Gibson will need regular rechecks to ensure that the device is not only fitting well but that the device is still providing appropriate function to his affected limb.

For additional information: Colorado State University is conducting an ongoing study evaluating partial amputation in dogs. Read more here.


CRI Offers Sponsorship Opportunities.   

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CRI is now offering the following opportunities for sponsorship.

  • Place a Banner Ad in the CRI e-Newsletter
  • Sponsor a Lunch & Learn
  • Sponsor a Lunch
  • Sponsor a Dinner Presentation
  • Sponsor a Continuing Education Course

For complete details, download the Sponsorship Opportunities flier.

To become a sponsor, please contact Emily Selbe at emily@caninerehabinstitute.com.


efafd40a-b8e3-4335-ad9c-4be7fa228be4Thank You, Purina, for Your Support!    

Our sincere thanks to Purina for supporting our Canine Sports Medicine courses through Lunch & Learns throughout 2017.


0fe78a9c-ad5d-43b4-9d05-18b64d8a5c9cSign Up for an Email Newsletter from the American College of Veterinary Sports Medicine and Rehabilitation.      

The American College of Veterinary Sports Medicine and Rehabilitation has a monthly newsletter edited by Dr. Janet Van Dyke, CRI founder and CEO. If you are interested in receiving regular updates from the college, sign up for this newsletter by going to the ACVSMR website.


Compassion Fatigue – Are You at Risk?

If you find yourself emotionally and physically exhausted, easily irritated and blaming others for problems on a daily basis, you could be suffering from compassion fatigue. Spiral Coaching offers a unique approach to actions that avoid compassion fatigue. Read our full blog here …

Gwen Pettit of Spiral Coaching has worked with CRI faculty and graduates for more than four years and brings 30 years of leadership and management experience to coaching. Gwen is a business owner and life coach who believes that you can create a life that is healthy, happy and professionally fulfilling.

c20d4f8b-6ecc-43ab-a9cd-c04b493bfbdaGwen Pettit, MA, PT, PCC
970-275-0323 or gpspiral@gmail.com
Spiral Coaching: Creating a Path towards Change

Thank You to the Following Sponsors for Their Support!

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4c68fe58-3848-4ee2-8d17-6f2a3efe4d09
3e0f3a89-9bb0-4396-b4a3-535ae1be3753
6a87294b-b98d-4ecd-9356-e696d28b5868

87ba7ab1-7abc-47c3-b237-46f85cc1efe6CRI courses are held year-round in locations across the country. Visit our website at www.caninerehabinstitute.com for more information including a complete course calendar.

Don’t forget that CCRTs and CCRAs are eligible for a 10% discount on most CRI Continuing Education Courses!

OrthoPets ACORN Stifle Study- University of Louisville Stifle Brace Study

Bertocci, Gina E., and Nathan P. Brown, “Biomechanics of an orthosis-managed cranial cruciate ligament-deficient canine stifle joint predicted by use of a computer model.” American Journal of Veterinary Research 78.1 (2017): 27-35.

http://avmajournals.avma.org/doi/abs/10.2460/ajvr.78.1.27


Picture2.pngOBJECTIVE

To evaluate effects of an orthosis on biomechanics of a cranial cruciate ligament (CrCL)–deficient canine stifle joint by use of a 3-D quasistatic rigid-body pelvic limb computer model simulating the stance phase of gait and to investigate influences of orthosis hinge stiffness (durometer).

SAMPLE

A previously developed computer simulation model for a healthy 33-kg 5-year-old neutered Golden Retriever.

PROCEDURES

A custom stifle joint orthosis was implemented in the CrCL-deficient pelvic limb computer simulation model. Ligament loads, relative tibial translation, and relative tibial rotation in the orthosis-stabilized stifle joint (baseline scenario; high-durometer hinge) were determined and compared with values for CrCL-intact and CrCL-deficient stifle joints. Sensitivity analysis was conducted to evaluate the influence of orthosis hinge stiffness on model outcome measures.

RESULTS

The orthosis decreased loads placed on the caudal cruciate and lateral collateral ligaments and increased load placed on the medial collateral ligament, compared with loads for the CrCL-intact stifle joint. Ligament loads were decreased in the orthosis-managed CrCL-deficient stifle joint, compared with loads for the CrCL-deficient stifle joint. Relative tibial translation and rotation decreased but were not eliminated after orthosis management. Increased orthosis hinge stiffness reduced tibial translation and rotation, whereas decreased hinge stiffness increased internal tibial rotation, compared with values for the baseline scenario.

CONCLUSIONS AND CLINICAL RELEVANCE

Stifle joint biomechanics were improved following orthosis implementation, compared with biomechanics of the CrCL-deficient stifle joint. Orthosis hinge stiffness influenced stifle joint biomechanics. An orthosis may be a viable option to stabilize a CrCL-deficient canine stifle joint.


Key pointsPicture1.png

Introduction:

  • Orthoses for CCLD have been reported. Their efficacy is dependent on device, owner, care-provider (adjustment, fitting of device and rehabilitation) and animal factors.
  • Orthosis allows limited functional movement (rather than complete immobilization) according to 4-point force application system used in humans with ACL-tears with the following cranial constraints (quads, tibial tuberosity, distal tibia) and caudal constraints (semimembranosus and semitendinosus, gastrocnemius muscles and calcanean tendon)
  • However, stabilizing effect of canine stifle orthosis has not been investigated

Materials and Methods:

  • Previously developed and validated computer model (3-D quasi-static based on 33kg Golden Retriever) utilized to test Orthopets CCLD-orthosis (with 2 Tamarack hinges at stifle) that was molded specifically for the dog that the computer model was based on
  • A 3-D scan of the orthosis was then performed to import the orthosis into the previously developed stifle model and loads on the ligaments (caudal CL, MCL, LCL) and tibial rotation and translation (drawer) through stance phase were compared between CrCL-intact, CrCL-deficient and CrCl-intact and -deficient with Orthopets orthosis
  • Different hinge stiffness (Tamarack 740-L [high] and Vet-L-65 [low stiffness]) were also evaluated

Results:

  • CrCL-deficient stifle compared to orthosis-managed CrCL-deficient stifle showed reduced tibial translation (91%) and rotation (61%)
  • CrCL-intact stifle compared to orthosis (with CrCL-intact stifle) showed significantly different peak loads (i.e. orthosis changes the loads compared to an intact stifle):
    • Loads on the caudal cruciate (38%) and lateral collateral ligament (53%) were reduced while MCL increased (50%)
  • CrCL-deficient stifle compared to orthosis-managed CrCL-deficient stifle showed significantly decreased peak loads for all ligaments tested:
    • Caudal cruciate (90%), lateral collateral ligament (93%) and MCL (59%)
  • Hinge stiffness significantly impacted tibial rotation (decreasing rotation with increasing hinge stiffness)

Discussion:

  • Stifle orthosis for CrCL-deficient stifle reduced translational instability by 90% in this computer-model
    • The tested device (Orthopets stifle orthosis) significantly improved biomechanical stifle stability in the stifle with cranial cruciate ligament deficiency
  • Stifle orthosis for CrCL-deficient stifle decreased loads on the collateral ligaments and caudal cruciate ligaments in this computer-model
    • The tested device (Orthopets stifle orthosis) may prevent subsequent injury to ligamentous structures
    • The tested design appears to reduce loading of the lateral collateral ligament to a greater degree than medial collateral ligament
  • Hinge stiffness had the greatest impact on tibial rotation
    • If greater control of internal tibial rotation is required (such as pivot-shift cases) a stiffer hinge should be considered
  • While computer models have been previously validated and appear highly predictive some variables are introduced when using a ‘real’ patient that may change these results (such as the cuffs were ‘modeled’ as a straight line, the foam may compress over time etc.) – in other words the result of this model are likely superior to what can be accomplished in a clinical patient
  • Modeling limited because it was based on one patient at one time-point only
Levi

Levi

Hello LiLen and all of the wonderful OrthoPets team,

I spoke to Lilen this morning about my dog Levi who two years ago was suffering from a cruciate tear in his left rear leg. OrthoPets fitted him with a stifle brace and the whole process was so positive. At that time he was just 14 and I was uncertain about his ability to bounce back from such an injury at his age. I am very proud to say that this spring he will turn 17 years old!!! He no longer needs his OrthoPets stifle brace but he took to wearing it almost immediately.

The stifle brace gave his leg the stability to heal while keeping him active – this to me is the genius of these braces. At his age mobility is EVERYTHING!!!

When he was 12 he tore his right leg cruciate and I opted to have surgery. It took a full 6 months for him to be able to walk and move freely again and consequently he lost much of his muscle tone and mobility. While I don’t regret my decision (and recognize that surgery is the best course of action in some cases) the process was so arduous and tentative. It was so amazing to have the option to use the OrthoPets brace and be a lot more proactive in the healing process – and to be able to keep him moving!

I am so grateful everyday that somehow I connected with OrthoPets. Without their help, I would not be enjoying each and everyday with my happy and healthy pup! Thank you a million times over!!!

Sincerely,
Courtney and Levi

January 2017 Email News from the Canine Rehabilitation Institute

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1f43d7b6-07e9-4520-a967-847132b84949.jpgIn Our January 2017 Issue …

  • Register Now for Our Advanced Therapist Class!
  • Last Chance for January Therapist in Australia!
  • See Us in February at NAVC and APTA’s CSM!
  • Three More Spring Courses Are Now Open for Registration!
  • Save the Dates for June-December Courses!
  • Registration Is Open for Spring Courses in Germany!
  • Take Our Survey About CE Courses … and more!

 


Register Now for Our Brand-New Advanced Therapist Class!

99e23158-eaf4-4410-8f2c-6de2cf176de5Are you an experienced, rehabilitation-certified veterinarian or physical therapist ready to take your knowledge and skills to the next level?

Don’t miss the opportunity for more in-depth learning with CRI’s brand-new course, Advanced Canine Rehabilitation Therapist,

being held March 3-5 at our Coral Springs, Florida location.

This course is RACE approved by the AAVSB for 20 CE hours for veterinarians.

During this course, you and your peers will advance the basic manual skills you learned in the Canine Rehabilitation Therapist module to a higher level. This practical and case-oriented course will have strong emphasis on the spine and will focus on advanced joint mobilization techniques of the extremities. Participants will receive ample hands-on experience with dogs on site.

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Ellen Martens, PT

The primary faculty member is Ellen Martens, PT, MT, CCRT, who has worked with our Canine Rehabilitation Therapist team for several years to create this course, which will be the first in a series of Advanced Therapist modules.

Ellen is known to many of our graduates who have been fortunate enough to intern at her canine rehabilitation facility in Velm, Belgium. Ellen has more than 15 years of experience in human physical therapy with extensive training in manual therapy, as well as canine rehabilitation and canine and equine osteopathy. Ellen has lectured around the globe and is a guest lecturer at prestigious universities throughout Europe on the topics of canine and equine manual therapies, canine sports conditioning, gait analysis, and injury prevention. We are honored to have her teaching our Advanced Therapist module!

This 2.5-day course is open to veterinarians and physical therapists who have successfully completed their CCRT and have at least one year of experience in canine rehabilitation. Veterinarians and physical therapists certified as Canine Rehabilitation Practitioners (CCRP) who have completed CRI’s Canine Rehabilitation Therapist module and have at least one year of experience in canine rehabilitation are also welcome. Good basic manual skills are expected.

Visit the Advanced Canine Rehabilitation Therapist course page to learn more, and register online today to reserve your seat!

 


Last Chance! Our January Therapist Course in Australia Starts in a Week!

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CRI faculty members enjoy time in Sydney after the October 2016 class.

We’re headed back to Australia January 28-February 1 to hold Canine Rehabilitation and Sports Therapy (Canine Rehabilitation Therapist module) at the Albion Park Raceway outside Brisbane.

If you have already completed Introduction to Canine Rehabilitation in Australia, Europe or the USA, but not yet taken the Therapist course, this is a great opportunity to join us and complete another course for certification! Veterinarians and physiotherapists who are CCRPs are also welcome.85a587ec-6508-4e77-b616-59e73bebb7a4

To learn more or register online, visit the VetPrac website or see the Australian Program page of our website. If you have questions, please email Dr. Ilana Mendels of VetPrac at we.help@vetprac.com.

Interested in attending further courses with CRI in Australia?  Please contact us at info@caninerehabinstitute.com.


See Us in February at NAVC and at APTA’s Combined Sections Meeting!untiled

Will you be attending the NAVC Conference or APTA’s Combined Sections Meeting? CRI will be in the exhibit hall at NAVC in Orlando February 4-8 and the APTA’s Combined Sections Meeting in San Antonio on February 15-18.

Graduates, students, and all interested parties are encouraged to stop by and say hello!


In the Words of Our Students … 

“I so admire the ease with which the PTs transferred, hopefully with some measure of success, their vast knowledge to our eager hands and brains. Every one of them was incredibly patient with us, our occasional hypoglycemic brain fog notwithstanding. It’s obvious they’re ALL passionate about what they do; I’m hoping I can live up to their high standards for animal care. … Of the three major commitments I’ve made to post-grad certifications, the CRI course is undoubtedly the best organized and most conducive to learning. The course will be highly relevant to my daily practice. I’m stoked to see how much more effective I’ll be at helping my patients enjoy life.”

– Carla Wilkie, DVM, CVA, CVC, West Vancouver, British Columbia, Canada


Three More Spring Courses Are Now Open for Registration!bdc807d1-03c2-4fc7-97fa-5b6777edde9e.jpg

We have opened registration for three more spring courses in sunny Florida, and several other courses have just sold out. Don’t delay and miss your chance! Register today, and reserve your seat!

Registration is currently open for the following U.S. and international classes:

Please check our website for the most up-to-date course schedule.

Remember that we also offer discounted 2-course packages for either (1) The Canine Rehabilitation Therapist plus Canine Sports Medicine or (2) The Canine Rehabilitation Assistant plus Canine Sports Medicine. Please see the 2-Course Packages section at the bottom of the Online Registration page for more details. If you are not sure when you plan to take a course, you may choose the option of a “Future” class. “Future” registrations may be subject to tuition increases. (Learn more.)

If you have previously registered for a “Future” course and wish to attend a 2017 class that is now open for registration, be sure to contact CRI and tell us which course you would like to attend. This is the only way to guarantee you have a seat in the course.

Don’t wait – register today to reserve your seat!


Save the Dates for June-December Courses!

85704c66-3fc4-4e58-93bb-11664df995dbPlanning to take CRI courses later this year? We’ve added June-December courses to the Course Schedule page on the CRI website, so you can get these dates on your calendar and reserve time to attend.

Our summer and fall courses will take place at Wheat Ridge Animal Hospital‘s brand-new facility in Wheat Ridge, Colorado, just west of Denver (see article below). Construction is on track to wrap up in April, so we will be among the first to enjoy this beautiful new space!

Please check the Course Schedule page on our website, and save the dates for the courses you wish to take. Be sure to watch this newsletter for announcements of course openings.

 


Courses Begin This Summer in Wheat Ridge, Colorado!975f5a53-5be6-4e90-ae92-57c444b11b2f

Starting in June 2017, CRI will be holding its Colorado classes at the all-new Wheat Ridge Animal Hospital in Wheat Ridge, Colorado, located just west of Denver. The new hospital will include a state-of-the-art rehabilitation center and conference facilities. Construction is on schedule and expected to be complete by spring 2017.

Our first class at Wheat Ridge will be Introduction to Canine Rehabilitation from June 18-22, followed by Canine Sports Medicine from June 24-26.

The staff at CRI is excited about this new opportunity to partner with the team at Wheat Ridge and its parent company, Ethos Veterinary Health.

To follow the progress on the new building, see the construction photos posted in the NEW Wheat Ridge Animal Hospital album on Facebook.

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Left: Work continues on the front entrance of the new hospital. Right: Upstairs treatment area. This is the hub of the hospital. Photos: Steve Hostetler Photography


We Want Your Feedback on CE Courses – Take Our Survey!

d0594514-4b75-40e5-87aa-a46b9b80b50a.jpgWe’ve been working on our upcoming CE courses, and now we’d like to get your feedback!

Take our Geriatrics/Nutrition/Pain Management survey, and tell us which topics are most important to you! We will incorporate your feedback into these three CE courses, scheduled for August 11-13 in Colorado. If you are interested in taking any of these courses, be sure to indicate that in the survey and we will email you with advance notification.

Our plans for upcoming CE courses are:

Spring/Summer 2017:

August 11-13, 2017, Wheat Ridge Animal Hospital, Wheat Ridge, Colorado (outside Denver)

In the next 12-18 months:

Two new courses that we’ve had a lot of inquiries about:

  • Canine Massage
  • Advanced Canine Sports Medicine

Which classes are you most interested in, and which dates and locations do you prefer? Please let us know by emailing us at info@caninerehabinstitute.com. We will look at the responses before making final plans.

If you would like to attend our upcoming CE courses, please be sure to read future newsletters for the announcement of course openings.


Registration Is Open for Spring Courses in Germany!3779d6ae-2802-44bc-a9a6-af6435623aaf

Registration is now open for our two upcoming courses in Frankfurt, Germany!

We are offering Canine Sports Medicine from May 26-28 and Introduction to Canine Rehabilitation from May 30-June 3.

Both courses will once again be held at Tierärztliches Orthopädie Team Frankfurt (formerly known as Praxis für Tiermedizin & Chiropraktik) at its newly renovated facility in Frankfurt.

Visit our German Program page for more details about both courses and a link to register.


Registration Is Open for Canine Sports Medicine in the UK in September!0384fdbc-8290-499f-b45c-8dd515f3633b

The Canine Rehabilitation Institute is excited to be returning to the United Kingdom! We will be presenting our Canine Sports Medicine course September 2-4, 2017, at the University of Surrey’s new School of Veterinary Medicine. This brand-new veterinary school has amazing state-of-the-art facilities all in a beautiful park-like setting with hotels nearby in Guildford.

Visit our UK Program page for complete details and a registration link.

We plan to continue with the two remaining courses in our certification program – Introduction to Canine Rehabilitation and The Canine Rehabilitation Therapist – assuming we have sufficient demand. For more details, please see the UK Program page on our website.

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The Canine Sports Medicine course will be held at the University of Surrey’s brand-new School of Veterinary Medicine.

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CRI graduates Javier Gil Marinez-Darve, DVM, MRCVS, CCRT (left), Amy Watson, MA, VetMB, MRCVS, CCRT (third from left), and Pete van Dongen, DVM, Cert VR, MRCVS, CCRT (with his wife, Carry) met with CRI founder and CEO Dr. Janet Van Dyke (second from left) to work on logistics for the course.


CRI Graduates: Request Your Certificates!f0f62f96-57e8-4594-bb7f-9c2d0aa5ce33.jpg

CRI graduates: If you have finished your CCRT or CCRA certification, we would like to send you your certificate! If you have not yet submitted a certificate application, please be sure to do so. We have sent emails to a number of students, but have not received some responses. To request your certificate, please email Kathy Coffman at kathy@caninerehabinstitute.com.


Interested in Some Expert Advice for Your Practice?

Plans are in the works to offer a practice-consulting service to CRI students and graduates, led by CRI founder and CEO Dr. Janet Van Dyke and CRI faculty member Dr. Steve Steinberg who teaches The Business of Canine Rehabilitation. More details will be available in the months ahead. If you are interested, please email us at info@caninerehabinstitute.com.

Be Careful With Protected Terms Such as “Physical Therapy” and “Veterinary Medicine.” 

CRI students and graduates, please remember that you may only use protected terms such as “physical therapy” and “veterinary medicine” in your advertising materials if you are licensed in these fields. We discuss protected terms during Introduction to Canine Rehabilitation, and we hope everyone continues to remember and follow the recommendations provided.

CRI Graduates: Is Your Contact Information Still Correct?d418ed30-7d48-4d09-b27b-49ebe167334c

If you are a CRI graduate, please check your listing in the Find a Therapist online directory and make sure the contact information is correct. If you have any updates, please email Joyce Rudzitis, CRI’s chief operating officer.


OrthoPets Case Study: Bailey

We’ve asked our colleagues at OrthoPets to share case studies with us as a way of providing more education about orthotics and prosthetics.

Bailey is a 6-year-old MC Labrador that is currently a patient of one of our Partner Clinics in San Francisco. Dr. Illana Strubel, owner of A Well Adjusted Pet, has come to OrthoPets and studied the use of our orthotic and prosthetic devices to use with her patients.

Bailey presented in September 2016 with a history of toe touching weight-bearing and non-weight bearing lameness intermittently over the previous 4 months. The radiographs showed inflammation and DJD changes in the left stifle with mild changes in the right stifle as well. He had a medial buttress palpable bilaterally with minimal to no cranial drawer or tibial thrust palpable on awake evaluation. He did show adequate range of motion, was able to sit and lie squarely. His measurements showed a 1-2 cm muscle mass discrepancy between the left and right thighs on girth measurements. The radiographic and physical exam conclusion was that they suspected a chronic partial to complete cranial cruciate ligament tear, +/- meniscal injury, with secondary degenerative change and crus muscle disuse atrophy for the left stifle. The conclusion for the right stifle was suspicion for equivocal increase of right stifle joint fluid volume with minimal tibial osteophyte; concern for possible early/mild partial cranial cruciate ligament tear and +/- meniscal injury.

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The owners’ goal was to avoid surgery on the left pelvic limb and increase Bailey’s comfort. Due to his discomfort, they had to decrease his walks, which led to a 10-pound weight gain. When OrthoPets received Bailey’s measurements, fiberglass impression and media, we were able to analyze his gait to determine the most appropriate orthotic design for him. In some cases, when a pet has non-prominent malleoli or an extended terminal stance tarsal angle, a tarsal cuff component is required for suspension of the orthosis because standard use of the tarsal anatomy will not be sufficient.

Bailey was fit with his stifle orthosis and has been doing very well. He is continuing his rehabilitation with Dr. Strubel. She reports that he is building back muscle mass and has been able to go on walks with the dog walker to get his weight back on track. His owners are very pleased with his progress, and best of all Bailey is happy!

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CRI Offers Sponsorship Opportunities.e37f3f32-5502-41a9-9758-70ef2b788082

CRI is now offering the following opportunities for sponsorship.

  • Place a Banner Ad in the CRI e-Newsletter
  • Sponsor a Lunch & Learn
  • Sponsor a Lunch
  • Sponsor a Dinner Presentation
  • Sponsor a Continuing Education Course

For complete details, download the Sponsorship Opportunities flier.

To become a sponsor, please contact Emily Selbe at emily.selbe@att.net.


efafd40a-b8e3-4335-ad9c-4be7fa228be4Thank You, Purina, for Your Support!    

Our sincere thanks to Purina for supporting our Canine Sports Medicine courses through Lunch & Learns throughout 2016.


0fe78a9c-ad5d-43b4-9d05-18b64d8a5c9cSign Up for an Email Newsletter from the American College of Veterinary Sports Medicine and Rehabilitation.      

The American College of Veterinary Sports Medicine and Rehabilitation has a monthly newsletter edited by Dr. Janet Van Dyke, CRI founder and CEO. If you are interested in receiving regular updates from the college, sign up for this newsletter by going to the ACVSMR website.


Thank You to the Following Sponsors for Their Support!

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4c68fe58-3848-4ee2-8d17-6f2a3efe4d09

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87ba7ab1-7abc-47c3-b237-46f85cc1efe6CRI courses are held year-round in locations across the country. Visit our website at www.caninerehabinstitute.com for more information including a complete course calendar.

Don’t forget that CCRTs and CCRAs are eligible for a 10% discount on most CRI Continuing Education Courses!

December 2016 Email News from the Canine Rehabilitation Institute

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In Our December 2016 Issue …

  • unnamed.jpgYes, You Can Conduct Clinical Research! Get Started in January With Our Online Course.
  • Registration Opens January 1 for Our Brand-New Advanced Therapist Class!
  • Register Now for Our January Course in Australia!
  • Registration Opens January 1 for the Canine Rehabilitation Assistant!
  • Registration Is Open for Our Spring Courses in Germany!
  • See Us in February at NAVC and APTA’s CSM!
  • We Want Your Feedback About Our 2017 CE Classes … and more!

read more…

October 2016 Email News from the Canine Rehabilitation Institute

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In Our October 2016 Issue ….unnamed

Registration Is Open for March 2017 Classes!

Our Next Online Clinical Research Course Starts in January

We Had a Great Time in Australia … and We’re Going Back in January!

We’re Headed Back to the UK and Germany in 2017!

New Construction Pics from Wheat Ridge Animal Hospital

Pawsitive Changes: Project V.E.T.S. … and more!

read more…