We are pleased to share our recent conversation with Debbie Gross, founder and owner of Wizard of Paws. In addition, she is the co-owner of TotoFit, a company dedicated to quality safe canine exercise equipment. She is one of the founders and core instructors for the first and only university-based program in canine physical rehabilitation, University of Tennessee's Certificate Program in Canine Physical Rehabilitation. She maintains membership with a variety of groups and sits on the advisory board of organizations inclusive of the American Physical Therapist Special Interest Group, International Veterinary Academy of Pain Management (IVAPM) and the Fear Free committee. Debbie is committed to educating the veterinary community about the value of rehabilitation and fitness through video, public speaking engagements, and print media.
Assisi: What do you offer at Wizard of Paws?
Debbie Gross: We do a combination of rehabilitation and conditioning at Wizard of Paws. If it doesn't fall into rehab, it's in general conditioning - and the conditioning could be for an athletic dog, or just a dog that needs to lose weight or increase their strength. They're all cleared by veterinarians for the conditioning part, as well as the rehab part. We see anything from post-op orthopedic, to neurological issues, to senior dogs and end-of-life issues. We do a lot with performance dogs. Our motto is, 'Every dog deserves to live the best quality of life for the longest time possible.'
We have a lot of different exercise equipment; underwater treadmills, land treadmills, static and dynamic gait analysis. We also offer a variety of exercises, again ranging from the dog that's having trouble standing, to the dog that's going to be competing out in the field for eight hours. As far as modalities, we offer laser therapy, cryotherapy, manual therapies, range of motion, massage, and joint mobilization. On staff we have two chiropractors that are also available to see dogs. It's a fun place!
What is the difference between rehab and conditioning?
In rehab, there's a problem or dysfunction. It could be pain associated with osteoarthritis, or a post operative lesion, or a muscle strain such as an iliopsoas issue. Those are requiring more in-depth treatment. We take the multi-modal approach to decrease pain and inflammation while concurrently improving strength and function. Dogs that are in for conditioning should have no problems. They come in for exercise only, so it's not as skilled as the rehabilitation component.
What kind of competition dogs do you see?
Everything from agility dogs, to hunting dogs, to schutzhund dogs, to dogs that just want to lose weight. There are probably twenty different sports that we'll see dogs for. Also, for fun, we offer a program where owner and the dog can come to an exercise class together.
That's fun. What kind of exercises do they do together?
A lot of it is based on balance exercises; for example, while the owner is doing a wall squat, the dog can do sit and stand, so they're both doing different forms of legs strengthening and core strengthening, so it's fun.
Rehab-wise, what do most people come in for?
Probably a third of them are some sort of orthopedic disease, whether it's cruciate disease, post-operative and non-operative, hip dysplasia, elbow dysplasia, a lot of soft tissue injuries - anything from injuries to the toes or the digits - iliopsoas injuries, or sporting injuries, that sort of stuff.
Is there a number one mistake that people keep making? What would you tell people if you could?
I always try to tell owners two things. First, listen to their dogs. If their dogs are limping, it's a sign of something going on, and the sooner that we catch it and address it, the better off they'll be. What I've found is owners know their dogs 99% better than anybody else, and they just don't always listen to their instincts. The second thing would be weight, even a couple pounds can have such ramifications on the dog's body.
What got you into the field of rehab and conditioning?
I was a human physical therapist, and always loved working with animals. While I went through physical therapy school, I kept just imagining what I would do with animals. At the time I had an Alaskan malamute that was older, and he became a great guinea pig to try just to figure out how their joints move. And so that thought was always in my head.
I was in human practice for quite some time, and I began learning as much as possible about animals, spending time with as many veterinarians as I could. I started working with a few veterinarians about improving dogs' lives. Something as simple as how we know that most, if not all humans, receive physical therapy immediately post-op. So why not transfer that over to the animal side?
And it kind of evolved from there, and I've been teaching on the topic for sixteen or seventeen years. It's been lovely to watch the progression, with canine rehab becoming more and more common. I love that owners are asking to try rehab before surgery. On the human side, we want to do surgery as the last option, and that's not always the case on the animal side. Offering other alternatives for animals and their owners has been quite nice.
Can you talk a little bit about what you like about alternatives to traditional veterinary care?
I think more and more owners are becoming more knowledgeable and inquisitive about alternatives. What I'm finding is the majority of owners already researched the ramifications of NSAIDs on their own, by the time they come in they were referred in from a vet and they're seeking alternatives. There's really no satisfaction in the owners just giving a pill. So if the owner's actually involved with something, whether it be rehab or putting the Assisi Loop on at home, there's a big difference.
There's always an alternative, there's many ways to get to the same solution. I'm finding more and more owners are seeking alternatives on their own. I think NSAIDs for pain management absolutely play such a necessary role, but I would probably have to say, seven or eight out of ten owners, one of their goals when we talk about their initial visit is they want to get their dog off the medication as quickly as possible. So it's wonderful to offer them another option.
How have you used the Assisi Loop at your practice?
There's an owner that's in Vermont, so she's almost four hours from me. her border collie had a bilateral stress fracture on its wrist. It's a working dog, he's a herding dog, he works sheep every day. The owner's husband is a retired baseball player and they had done all this research about drugs and they wanted to treat him from a more natural standpoint. They had come down for an initial evaluation, and I lasered the dog, and said, 'Let's try the Loop. I'm going to send you home with this and let's see.' And she just cannot say enough great things about it. The dog has never been on any anti-inflammatories and is being treated pretty much with exercise and the Loop, and he's back to herding and working.
We also use it on osteoarthritis, post op, cranial cruciates, where again the owner can't come in as frequently and is looking for pain relief, or the dog may not be able to take NSAIDs. We've really tried it on a variety of things and I've been very happy with the results. There's one thing we really take into account, which is the owner's perception. But we also get objective measurements, with the static and dynamic gait analysis. We've had nice results.
You are a member of IVAPM, which is a great organization since the whole concept of animals feeling pain is, strangely, kind of a new concept. Some people don't understand that limping means pain.
Oh yeah, I still see that every day. Trying to get owners to understand if the dogs are lame, especially if it's all a sudden, that there's some source of pain. We do a lot of education on pain. What I find is once owners see their dogs not in pain, then they can relate to it completely. Once the owners understand what pain is, then we're golden. But there' still a huge amount of education, and we really try to go over with the owners, have them relate it as much back to them as possible for adequate pain management. It's still a struggle, but by the time the pet owners get to us, they're aware of it, but maybe not to the exact degree.
Once they see it, like 'oh my gosh, my dog is running around like a puppy, I didn't know they were in that much pain,' and then they feel awful. But we don't want them to feel bad, because by the time they have approached us and come through our doors, they've taken positive steps, and we always want to encourage owners that they're doing fantastic - so we just want to improve it even more.
Is there anything important you'd like to add?
I think that as more and more awareness comes into pain management, I can't stress enough the whole 'multi-modal' approach. We always want to decrease pain and inflammation but we also want to improve strength, and that's how we really get the results we want - not temporary results, we're not just putting a Band-Aid on it. I'll hear people say 'Oh, we tried this,' whether it's the Loop or laser, 'and it did nothing,' - well, any given modality is just a piece of the puzzle.
People kind of want to do one thing and have that fix it, but that is rarely the case.
Exactly, and so often in animals, there is the combination of that it may not just be the one area, there's secondary and tertiary issues, or their weight, then there are other things - but nothing is just a band-aid, it's just pieces of the puzzle that we're going to put together and help the dog.
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