Thursday, April 5, 2012

An open letter to the National Association of Veterinary Technicians in America (NAVTA)

My chosen profession is near and dear to my heart.  I worked hard to get into veterinary technology and make my way through school.  I worked hard to develop my skills and be the best veterinary technician that I could.  And I worked hard to pursue my passion and earn a living doing what I love..  I cannot say the same for my professional organization, however.  I do not feel that NAVTA is working hard for me.

Upon receiving an email in my inbox this morning from Andrea Ball, executive director of NAVTA, inquiring as to why I had not renewed my membership, I chose to share with her exactly WHY I did not renew:


Hello Andrea,
Thank you for the reminder email regarding my membership renewal.  However, I did not forget to renew my NAVTA membership.  Rather, I chose not to renew on the basis that the organization no longer fully represents my, nor my colleague’s, interests as a credentialed veterinary technician.  As previously stated by NAVTA:

“The National Association of Veterinary Technicians in America (NAVTA) is a non-profit association that represents and promotes the profession of Veterinary Technology. Incorporated in 1981, NAVTA is the national organization devoted exclusively to developing and enhancing the profession of veterinary technology, through education, advocacy and promotion within the industry and to the general public. NAVTA is committed to education, career growth and the advancement of its members.”

With the advent of the veterinary assistant training program and active pursuit of assistant members, NAVTA is no longer exclusively supporting the profession of veterinary technology.  In fact, NAVTA is diluting its support of the credentialed veterinary technician, and further muddying the waters with regard to defining the veterinary technology profession.

Please do not misinterpret my comments as disparaging to the development of veterinary assistant training programs.  On the contrary, I fully support the continued education of all members of the veterinary healthcare team.  I feel, though, that NAVTA’s involvement in this initiative was premature and, at best, not well thought out with regard to the overall image that NAVTA should portray.    I do not see the American Nurses Association training phlebotomists, or CNA’s.  These ancillary roles in human medicine have their own organizations. So why would NAVTA take on such a role? Certainly NAVTA could have been supportive of an initiative to develop a stand-alone veterinary assistant organization and training program, independent of NAVTA.

Veterinary technology as a whole is still a very young and quickly growing profession.  We are in need of close observation of national and international trends in our field, and careful development of programs to cultivate an environment in veterinary medicine where credentialed technicians are sought after.  To earn my support I need to see NAVTA stay true to the needs of, and be a strong advocate for, the credentialed veterinary technician.

Kindest regards,

Maggie



Maggie Lump, BS, RVT
President-Elect
Indiana Veterinary Technician Association

Instructional Technologist
Purdue University College of Veterinary Medicine
Veterinary Technology Program


Keep away from people who try to belittle your ambitions. Small people always do that, but the really great make you feel that you, too, can become great.  ~~Mark Twain

An open letter to the National Association of Veterinary Technicians in America


Wednesday, September 21, 2011

Practical Application of Physical Rehabilitation

Maggie Lump, BS, RVT, CCRP (Candidate)
Instructional Technologist
Purdue University Veterinary Technology Program

Physical rehabilitation of the canine and feline patient is a team approach.  From the veterinarian’s diagnosis, to the rehabilitation practitioner’s exercise plan, the owner’s observations, as well as input from other professionals such as a groomer or trainer; everyone has something to offer.  The patient itself must also be considered as part of this team, as their behavior gives input to the treatment plan as well.  We must not focus solely on the injury, only to lose sight of the patient’s overall mental and physical status.  Therefore, it cannot be stressed enough that clear communication and involvement of all members plays a crucial role in obtaining the best possible outcome for the patient. 

There are many therapeutic modalities that are used in physical rehabilitation of the dog and cat.  These include manual therapy, thermal agents, electrotherapeutic techniques, mechanical agents, and therapeutic exercise.  Some of these modalities require no more than two hands and a lot of patience, while others require specific facilities and equipment.  For the purpose of this discussion we will focus on the modalities that can be implemented in practice without the need for major equipment purchases.

Manual Therapy
Manual therapy includes massage, stretches, joint and soft tissue mobilization, and chiropractic manipulation.

Massage is beneficial in promoting circulation and lymphatic drainage, mobilization of tissues to break down adhesions, relaxation of muscle and reduction of spasms.  There are many different types of massage strokes, each providing their own unique benefit.  These include efflurage, petrissage, tui-na, TTouch, and myofascial release. The act of grooming alone can be a very beneficial form of massage.

Stretching relieves pain and loosen tight muscles.  It relieves stiffness related to inactivity.  When used before exercise, stretching preemptively protects muscle from strain.  After injury, stretching both restores and maintains normal muscle length. 

Passive Range of Motion (PROM) is the movement of joints through their normal range of movement without stretching or active muscle action.  This is done by the practitioner moving the limb while the pet is in a non-weight bearing position (typically lateral recumbency).  PROM is used to detect restrictions or pain, restore joint motion, and enhance joint lubrication and nutrition.

Acupuncture stimulates specific points on the body with the use of small needles. These needles stimulate the neurological and endocrine systems, prompting pain relief and promoting tissue healing.  Acupressure, however, is where the practitioner uses his/her own body (hand, fingers, elbow) to apply pressure to the same points used in acupuncture.  Acupuncture needles can only be inserted by a veterinarian trained in this modality.  However, a veterinary technician can provide acupressure to patients with appropriate training.

Thermal Agents
Cold threapy is applied as a cold bath or ice pack.  It constricts the capillaries, thereby reducing pain, swelling, and inflammation. For acute injury, the use of cold therapy within the first 24-48 hours after injury can help to slow the inflammatory process.

Heat threapy is applied via moist heat packs or infrared applications. Topical heat application does not penetrate deep through tissue, therefore it is most beneficial for superficial muscles and joints.  Heat increases circulation and speeds up metabolism.  It also aids in the relaxation of muscles and reduction of muscle spasm. Heat also increases the pliability of tendons, ligaments and joint capsules, which allows for an increased ability to stretch. 

Electrical Therapy
Electrical therapy includes low level laser therapy, electro-acupuncture, and pulsed magnetic field therapy.

Electrical muscle stimulation (EMS) is the application of low electrical current through muscle motor points in order to stimulate muscle contraction.  Electrical muscle stimulation retards muscle atrophy, re-educates weak muscle, and encourages delivery of nutrients to the area.

Transcutaneous electrical nerve stimulation (TENS) is the application of low electrical current through tissue to counteract the pain cycle.  TENS relieves muscle spasm and stimulates the release of endorphins.

Mechanical Therapy
Mechanical therapy include therapeutic ultrasound, acupuncture, extracorporeal shock wave therapy (ESWT), and mechanical vibration/massage.

Therapeutic Exercise
Therapeutic exercise is arguably the single most important component of a rehabilitation program.  The exercises performed and the intensity at which they are performed depends upon the initial diagnosis, patient’s pain/discomfort, goals of the client and veterinarian, and the facilities that are available.

Therapeutic exercise includes the use of a treadmill, underwater treadmill, or swimming pool.  These tools may or may not be available in clinical practice.  However, with proper client education and strong owner compliance, pools and treadmills may be considered for use if available in the home environment.

Exercises include: leash walking, dancing/wheelbarrowing, use of exercise balls or physiorolls, isometric exercises, stair climbing/decent and walking over or around obstacles such as weave poles, cavaletti rails or other agility-type equipment.  A change in the substrate or terrain which exercises are performed on can also be incorporated if available to increase difficulty or target specific muscle groups.  For example walking on soft sand, landscape mulch, though tall grass, or even snow may be implemented to provide both mental and physical stimulation.

Other important components of rehabilitation in the dog and cat that bear mentioning include orthotic devices (thermoplastic splints, boots, and custom wraps), carts and wheelchairs, maintaining a high plane of nutrition, and provision of an environment suitable to healing.

The primary goals of any rehabilitation program are to decrease pain, provide a gradual return to normal function, improve strength and coordination and provide mental stimulation.  Every plan must be tailored specifically to the needs of the individual patient.  As time progresses the plan will need to be modified in order to meet the changing needs of the patient.

Rehabilitation Resources
Journals:
Veterinary Clinics - Small Animal  Nov 2005 (35:6) - Rehabilitation Issue
Veterinary Medicine/Veterinary Technician/Compendium articles
International Veterinary Information Service - http://www.ivis.org

Certificate Programs:
University of Tennessee - http://www.utcaninerehab.com
Canine Rehabilitation Institute- http://www.caninerehabinstitute.com
Chi Institute: Traditional Chinese Medicine for Veterinary Technicians - http://www.tcvm.com/Program/outline/vettech_outline.htm

Associations:
American Canine Sports Medicine Association - http://www.acsma.org
International Veterinary Academy of Pain Management - http://www.ivapm.org
International Association of Veterinary Rehabilitation and Physical Therapy - http://www.iavrpt.org
International Association of Animal Massage and Bodywork - http://www.iaamb.org

Books:
Canine Rehabilitation and Physical Therapy – Millis, Levine & Taylor
Animal Physiotherapy – McGowan, Goff & Stubbs
Essential Facts of Physiotherapy in Dogs and Cats – Bockstahler, Levine & Millis
The 5-minute Veterinary Consult Canine and Feline Specialty Handbook Musculoskeletal Disorders
Canine Physical Therapy – Debbie Gross Saunders, Wizard of Paws

Meetings/Workshops:
Many large veterinary CE meetings now offer tracks in rehabilitation, sports medicine, and complementary medicine
IAVRPT International Symposium on Veterinary Rehabilitation
2010 - http://vetrehabsymposium.weebly.com/
2012 - http://www.admicos.com/ISVR2012/


Thursday, February 4, 2010

The Basics of Animal Massage Therapy

Massage has been shown to be very beneficial for pets as well as humans. Our pets enjoy the same benefits, such as reducing stress, enhancing blood circulation, decreasing pain, improving sleep, reducing swelling, enhancing relaxation, and increasing oxygen capacity of the blood. Pain induced by muscle knots, excessive tightness, and muscle spasms can often be reduced or eliminated by massage alone. And massage is helpful in the breakdown of adhesions, or the sticking together of healing tissues, which can cause movement restrictions and discomfort.

It is possible to perform basic massage techniques on your own pet at home. As always, check with your veterinarian before performing massage if your pet has a medical condition. Massage is not recommended for some situations, such as active infections, pregnancy, and cancer.

When performing massage on your pet, keep in mind these guidelines:

Massage should never hurt. If your pet seems uncomfortable (restless, snaps, cries, or winces), use lighter pressure. If while using a light stroke your pet is still uncomfortable, then it is best to discontinue the massage.
Spending too much time in one area can cause soreness. Be sure to incorporate the whole body, and move from one area to the next in an orderly fashion. Approximately five minutes on each area should be a comfortable amount of time.
Always keep one hand on your pet for continuity. It can be distracting and confusing to your pet if you repeatedly touch them one minute, and not he next. (Remember how annoying it would be when your pesky brother or sister would poke you one minute, and then say "I'm not touching you" the next?)

Here is a brief overview of the most common massage strokes used:

Effleurage – A gliding motion following the contour of the body that can be done softly to relax the pet both when you first approach as well as at the conclusion of the massage. Begin moving down the pet (head to tail, shoulder to toes, hip to toes) in order to achieve a relaxing sensation. Benefits include increased circulation by dilating capillaries, increasing lymphatic circulation, relaxing and soothing the patient, and removing waste products, or “flushing”, the area massaged.
Petrissage – Rhythmic lifting of tissue in a circular, single or bi-directional pattern. Think about lifting the tissue from the bone and gently squeezing or milking. Circles and longitudinal strokes over muscle help broaden the tissue to make it more warm and elastic. Benefits include increased circulation (deeper than effleurage), removing toxins, reducing local swelling, relieving fatigue, improving cellular nutrition, mechanically relaxing the muscles, reducing muscle soreness/stiffness, and softening superficial connective tissue.
Skin Rolling – A form of Petrissage. The skin is lifted between the thumb and fingers and gently compressed, and then rolled as the fingers “walk” over the tissue. This can be performed in multiple directions. Benefits include loosening adhesions and releasing endorphins.
Friction – Brisk, often heat producing compressive strokes that may be done superficially to the skin or to deeper tissue layers. Benefits of friction massage include increasing circulation, loosening stiff muscles/joints, reorganizing collagen, reducing trigger point activity, and freeing restrictions caused by adhered tissues.

Also, keep in mind how you are giving the massage. There is a different sensation when using a flat, open palm versus using just your fingertips The massage technique is just as important as the massage stroke being used:

Superficial – The hands or fingers are drawn over the skin in a brisk back and forth motion.
Deep – The finger puts pressure on the body and then moves in small movements in different directions (up and down, back and forth, or circular).

Watch your pet's body language for signs of how much pressure you need to apply:

Too much: eyes opening or dilating, sudden faster breathing, glancing at you from the corner of their eye, sitting up, squirming, or moving away.
Just right: sighing, yawning, licking their lips, flatulence.

Friday, June 12, 2009

Which comes first, hip dysplasia or arthritis?

Often, arthritis and hip dysplasia are mentioned in the same breath. The two go hand in hand, but it is important for pet owners to note that arthritis and hip dysplasia are not one in the same.

Arthritis
Also known as Degenerative Joint Disease (DJD), arthritis (or osteoarthritis) is a progressive disease caused by the gradual loss of cartilage. This leads to the development of bony spurs and cysts along joint margins. Many factors play a role in the development and severity of arthritis, including a pet's age, conformation, weight, and overall health. All joints are susceptible to these changes, however it is most often noted in weight-bearing joints of the limbs, such as the shoulders, elbows, hips, and knees.

Pain and inflammation is often associated with arthritis, however those are only secondary signs resulting from a deeper, more complex process. The initial damage occurs long before these signs are noticed, when enzymes within the joint capsule set off a chain reaction of changes leading to collagen degradation, cartilage breakdown, and decreased elasticity of joint fluid. In the end, once the cartilage and joint fluid are no longer able to protect the bone, the friction caused by bone on bone movement damages the bone, thereby causing the pain and inflammation.

Hip Dysplasia
Hip dysplasia is a common cause for the development of arthritis in the hip joints. It is a genetic condition, where the hip joints are not formed properly, leading to a poor fit between the hip socket and the head of the femur. This developmental defect causes the weight placed on that joint to be distributed abnormally, which in turn causes cartilage damage.

To illustrate, think of purchasing a pair of shoes which are too large for your feet. As you walk, your feet move within the shoe, causing additional friction and leading to the development of inflammation and painful blisters. The same problem results for a joint where the bones do not fit together snugly.
So, it is the abnormal motion of the joint with hip dysplasia that then sets the stage for arthritis to occur down the road. However, wether your pet is diagnosed with hip dysplasia or not, it is still possible to have arthritis develop in the hips as a result of other factors (age, weight, traumatic injury to the joint, etc).

Signs that may be seen in pets with one or both conditions include:
Slow getting up in the morning, but improvement with activity throughout the day
Wobbly walk
"Bunny hops" when running
Difficulty going up stairs
Difficulty rising from a lying or sitting position
Muscle loss in the hind limbs
Rocking forward or shifting weight to the front limbs

No matter the cause, arthritis is best approached from a multimodal standpoint. This means developing a well-rounded plan that incorporates exercise, pain management, a well balanced diet, physical rehabilitation, joint supplements, and adjunctive therapies to gain the best possible outcome.

Sunday, May 31, 2009

Thank you!

It's when I receive comments like these that make my job so rewarding! Thank you to all of my wonderful clients who are truly dedicated to their pet's well-being!


"...I want to take Nelson (brindle Great Dane w/femoral head removal)[to your weekly dog fitness walk] so that you can see how well he's doing. He's literally a walking advertisement for your therapy program. And a running advertisement. And jumping. And playing. And so on. If you remember, he got a little spastic whenever we first go there. Now, he's like that all the time.
We took him and our American Bulldog/Pointer mix Rion for a ~3 mile walk this week. Rion crashed for two days. Nelson napped for a while and was ready for more."

Neil H.
(Owner of Nelson, Lafayette, IN)



"...Darby is doing well - although I do not see any more progress with mobility, she has not regressed either which of course is terrific. I certainly believe the therapy she received at your facility has her where she is today and as you know the prognosis was not good when we first arrived (if you recall she could not walk). Many thanks to you and the good Dr. for your hard work and caring approach. I am very grateful she is still with me. Thank you.

Hope all is well with you and your continuing education. Stay with it -
you are just the sort of person that is crucial to help people like
myself that are just bonkers for their animals."

Sincerely,
Steve P.
(Owner of Darby, Indianapolis, IN)

Thursday, May 7, 2009

Pets can win the battle of the bulge with our help. Let's get a handle on pet obesity by promoting healthy and active lifestyles.

Did you know that over 30 million dogs and cats in the US are overweight or obese?

An overweight pet is defined as weighing 10-19% over the ideal weight for their breed. While an obese pet is defined as weighing 20% or more over the ideal weight. So, to put this into perspective, just two pounds of excess weight on a 10-pound dog or cat, is equivalent to a human gaining 30 pounds. That can lead to some serious health implications, such as heart disease, diabetes mellitus, arthritis, and fatty liver disease.

Have you discovered your pet has a little extra baggage lately? Take notice if your pet: doesn't have palpable ribs, doesn't have an hourglass figure (loss of waistline), has a belly which hangs down, waddles when walking, and has difficulty getting around. The good news is that obesity is a condition that is correctable. The following are just a few steps to a healthier pet:

Step 1. Nutrition
Whether your pet needs to shed a lot of pounds, or just become more fit-and-trim, a solid nutritional foundation is key. It is important to have the right balance of quality, highly digestible nutrients that match your pet’s age and lifestyle.

Step 2. Pain Relief
If your pet is painful for any reason, that can be a barrier to leading a more active lifestyle. Your veterinarian is the best person to help you determine the most appropriate pain management options for your pet. There are many pain management options available that include the use of physical rehabilitation, dietary supplements, homeopathic remedies and prescription medications.

Step 3. Exercise
Keeping active is the key, so consistent activity can significantly decrease weight by demanding the body to burn more calories. As short as 5-10 minutes twice a day, three days a week can make a difference. Some pets, however, need additional guidance and support when starting an exercise regimen. Before having your pet begin any exercise program, consult with your veterinarian to make sure the activity level and supervision is appropriate for your pet's age and health status.

Getting an overweight pet started on a weight loss program can seem overwhelming at times. There is so much you want to do for your pet, and it can be difficult knowing where to start. Remember these points when your pet begins a weight loss program:

1. Set realistic goals.
Weight loss is a gradual process. If your pet is 25% overweight, it may take your pet several months to reach his or her target weight. Don't get discouraged if the weight is slow to come off at first.

2. Be conscious of how you feed your pet.
Closely supervise feedings if you have more than one pet to prevent food stealing between pets. Use a measuring cup to accurately determine the right amount to feed your pet, and divide the total amount to be fed each day into three or four small meals. The digestive tract as a whole is one of the largest organs of the body, and therefore requires a lot of energy to do its job. Feeding more frequent, smaller meals makes the digestive tract work more often, which in turn burns more calories than feeding one or two large meals.

3. Weight management takes commitment.
Your pet may require lifelong diet and exercise changes to maintain his or her ideal weight. Stick to the plan, and work closely with your veterinarian and rehabilitation provider when any adjustments are necessary. Your veterinary health care team will do whatever they can to help you and your pet succeed, so take their recommendations to heart.

For more information about pet obesity, visit the Association for Pet Obesity Prevention at www.petobesityprevention.com

Wednesday, May 6, 2009

Helping older pets get past the pain of arthritis.

As our pets get older, they experience the same trials and tribulations that we do: stiff joints, sore muscles, and arthritic changes. When our pets first experience pain associated with arthritis, they may alter their posture and activity level slightly to avoid the pain the best way that they can. This, in turn, causes added stress to other joints and muscles in the body to compensate for the initial injury. After a while, the parts of the body that are compensating to prevent the initial pain begin to wear out or become stiff themselves, causing more pain or discomfort.

Typically, our pets do not show signs of this pain until this cycle has been in full swing for some time. That's when we begin to see our pets have difficulty doing normal daily tasks, such as going up or down stairs, jumping up onto the couch, having to lay down while eating or drinking, or a decrease in playfulness. Changes in mood or behavior such as snapping, biting or growling may also be noted in an otherwise friendly and docile pet.


This reluctance to maintain normal activity leads to a more sedentary lifestyle because it simply hurts to move. However, the best cure is often exactly what our pet does not wish to do, which is keep active. We can break the vicious cycle by discussing with our veterinarian how to maximize the benefits from such treatment options as:

Pain Medications:
This includes traditional medications such as non-steroidal anti-inflammatories, as well as homeopathic herbal mixtures. Be sure to discuss with your veterinarian any over-the-counter remedies you may be giving your pet, as some may cause harmful interactions or negate the effects of the medications they prescribe.

Joint Supplements:
Utilize products that are available through your veterinarian such as chondroprotectants, glucosamine, chondroitin, MSM, and essential fatty acids. These products serve to protect any remaining cartilage and support overall joint health.

Physical Rehabilitation Programs:
Structured exercise programs that are designed to slowly return your pet to a more normal level of activity. Your pet may be introduced to activities such as swimming or controlled low-impact exercises to stimulate inactive muscles and promote strengthening and growth.

Well-balanced Diets:
It is important to feed a high quality, balanced diet to ensure the body is receiving the nutrients it needs. Your veterinarian or animal rehabilitation provider can help you determine the appropriate diet and amount to feed for your pet's lifestyle. Over feeding adds extra calories that will pack on added pounds, leading to more stress on already stressed joints.

Alternative Therapies:
Massage therapy, homeopathic treatments, acupuncture, chiropractic care, reiki, low-level laser therapy, and a host of others are all available for pets. Ask your veterinarian or animal rehabilitation provider if they perform these treatments, or recommend any knowledgeable pet practitioners in these fields.

Home Exercise Programs:
A home exercise routine can be developed with the help of your veterinarian and animal rehabilitation provider to maximize strength and increase endurance for your pet. This requires dedicated owners who are willing to consistently carry out the prescribed diet and exercise plan.

Implementing the above items, with the help of your veterinarian, will help develop a comprehensive and balanced plan of attack to end the pain cycle and improve your pet's quality of life.