Fear-Free Feline Rehab Tips and Tricks

1.  Implement a Fear-Free approach to practice, avoid “white coat syndrome.”

2.  Identify fear, anxiety, stress, before and during appointment and adjust plan after every session.

3.  Offer pharmaceutical interventions before and during appointment and for travel.

4.  Address pain management concerns concurrently with a Fear-Free approach.

5.  Use pheromone options.

6.  Have equipment ready and set up before cat arrives.

7.  “Cat proof room” hiding places.

8.  Provide appropriate safe hiding places.

9.  Schedule time for cat to arrive early and have private time with owner to get comfortable in facility, exit kennel on own, use litter box.

10.  Have owner present at appointment if appropriate (make game plan for owner role and behaviour and address concerns before beginning treatment).

11.  Reduce lighting and noise; i.e., barking dogs, fluorescent lights, washing machine and dryer use, traffic in and out of treatment area.

12.  Keep clinician/practitioner/technician consistent.

13.  Change clothes from “dog clothes,” if possible.

14.  Use minimal restraint, minimal handling.

15.  Underwater treadmill - have depth of water and speed set before starting appointment.

16.  Offer cat safe “jump out spot.”

17.  Keep sessions short (15–30 minutes).

18.  Offer breaks during appointment.

19.  Provide food rewards if desired.

20.  Set up equipment in small area to inspire use and direct pattern of travel to reward; i.e., safe place, owner, food reward.

21.  Offer kitten socialization times in your practice.

22.  Send equipment home with clients, have feline specific therapeutic exercise equipment.

23.  Have dedicated fear free planning time and evaluation of cases with practice team.

24.  Provide owner with opportunity to provide feedback after and between sessions.

25.  Celebrate success!

How Does Rehabilitation Benefit Your Practice?

• Constant development of the client-technician-patient relationship
• Technicians monitoring progress and reporting back to veterinarian decreases veterinarians recheck appointment schedule.
• Increased visits to the clinic = increased confidence
• in the clinic = increased loyalty to the clinic
• Can be a completely technician driven service similar to nutrition program = great technician job satisfaction

Constant monitoring and re-evaluation by all team members is a key component to success. Veterinary physical rehabilitation must not be performed without an assessment, diagnosis, and rehabilitation prescription being provided by a licensed veterinarian. Please review The Model of Standards for Veterinary Physical Rehabilitation Practice provided by The American Association of Rehabilitation Veterinarians (AARV) published February 7th, 2011.

Without Rehab?

Muscle mass deteriorates. Muscle mass deterioration continues during recovery period. *Make sure your clients are aware of this when setting goals* With disuse and loss of range of motion painful trigger points and spasms can develop.

Bones that are non-weight bearing loose density. Tendons and ligaments contract if unable to use full range of motion tendons.

Cartilage in a non-weight bearing limb becomes brittle and thin.

Synovial fluid in a non-weight bearing limb loses viscosity.

Without rehab mass deteriorates and continues during recovery period. With disuse and loss of range of motion painful trigger points and spasms can develop.

Bones that are non-weight bearing lose density. Tendons and ligaments contract; i.e., quadriceps contracture may develop if unable to use full range of motion. Cartilage in a non-weight bearing limb becomes brittle and thin. Synovial fluid in a non-weight bearing limb loses viscosity. Osteoarthritis, obesity, injury and surgery can cause muscle atrophy and weakening, decreased range of motion, and exercise intolerance. The goals of a complete rehabilitation program include: increasing range of motion, developing muscle mass, reducing pain, improving functional use of affected limb or area etc. Goals vary from case to case and should be determined by the client, attending clinicians, and support staff. Incorporate weight loss, weight maintenance, and cardiovascular fitness into all programs.

The “Tech-Centric” Model puts technicians at the centre of the practice and programming and streamlines communication between team members. The veterinarian can focus completely on the role of clinician and provides direction to the technician as required. The practice manager concentrates on growing and managing the practice and gives all necessary direction to the technician who is responsible for communicating with other team members and the clients. This creates technician job satisfaction by increasing responsibility and allowing technicians to develop long term and meaningful client relationships. Veterinary and client communication is still present but minimized with everything falling into the scope of RVT practice being delegated to the RVT.

The Benefits of The “Tech-Centric” Model Include:

• Increased revenue - Clinicians able to provide more revenue generating services and billable hours (able to confidently delegate other tasks)
• Increased client satisfaction - Consistent communication and perception of being attended to by a variety of team members in a consistent manner.
• Reduced technician turnover - Technicians having their own clients and increased responsibility = increased job satisfaction and ownership of job.
• Increased sense of team roles and defined responsibilities
• Streamlined efficient and seamless communication
• Increased efficiency due to improved communication and delegation of tasks to appropriate staff

What is the “Tech-Centric” Tech Made Of?

Creativity, Enthusiasm, and Excellent Client Relation Skills

• Variety of ‘tools’ in their ‘tool box’ relating to all aspects of nursing skills, diagnostics, technical skills, client relation abilities
• Compassion
• Problem-solving skills
• “Can-do” attitude
• Sense of humour
• Dedication
• “Jack of All Trades”
• Combination of leadership and team player skills
• Dedication to professional development
• Dedication to practice growth and development
• Willingness to educate colleagues and the community
• The list goes on….

References

1.  Radosta, Lisa. Behavior is Medicine. Fear Free is Better Medicine, Fear Free Symposium. 2018. https://fearfreepets.com/wp-content/uploads/delightful-downloads/2018/06/Symposium-Lisa-Radosta-Proceedings.pdf.

2.  Goldberg Mary Ellen (Editor), Shaffran Nancy (Consulting Editor). Pain Management for Veterinary Technicians and Nurses. Wiley Blackwell. 2014.

3.  Millis, Darryl L, Levine, David, Canine Rehabilitation and Physical Therapy 2nd Edition, Elsevier. 2014.

4.  Carver, Donna. Practical Physiotherapy for Veterinary Nurses. Wiley Blackwell. December 2015.

5.  Zink, Christine M (Editor), Van Dyke, Janet B (Editor). Canine Sports Medicine and Rehabilitation. Wiley Blackwell. 2013.

6.  Fox, Steven M. Multimodal Management of Canine Osteoarthritis. CRC Press, August 2016.

7.  Bockstahler, Barbara, Levine, David, Millis Darryl. Essential facts of physiotherapy in dogs and cats rehabilitation and pain management. Vet Verlag 2004.

8.  Epstein M, Rodan I, Griffenhagen G, et al. 2015 AAHA/AAFP Pain management guidelines for dogs & cats. J Am Anim Hosp Assoc 2015;51:67–84.

9.  Gaynor, James S. (Editor) Muir III, William W. (Editor), Handbook of Veterinary Pain Management, 3rd Edition, Elsevier. 2014.

10.  Mathews, KA. Pain assessment and general approach to management. Vet Clin North Am Small Anim Pract .2000;30:729–752.

11.  Mathews K, Kronen PW, Lascelles D, et al. Guidelines for Recognition, Assessment and Treatment of Pain. J Small Anim Pract. 2014;55:E10–68.

12.  University of Tennessee. www.canineequinerehab.com.

13.  Canine Rehabilitation Institute. www.caninerehabinstitute.com.

14.  International Association of Veterinary Rehabilitation and Physical Therapy. www.iavrpt.org.

15.  American Association of Rehabilitation Veterinarians. www.rehabvets.org.

16.  Academy of Physical Rehabilitation Veterinary Technicians. www.aprvt.com.

17.  International Veterinary Academy of Pain Management. www.ivapm.org.

18.  Debbie Torraca. www.wizardofpaws.net.

19.  Toto Fit. www.totofit.com. Follow their blog and like their Facebook Page!

20.  Therapaw boots, braces, supplies and advanced rehabilitation symposiums. www.therapaw.com.