INFORMATION FOR PATIENTS VISITING BISCUIT & BAILEYS LTD

INFORMATION FOR PATIENTS VISITING BISCUIT &
              BAILEYS LTD

What is hydrotherapy?
    A therapy programme, utilising the properties of water. To ensure safety and
    appropriate treatment, hydrotherapy should be carried out by appropriately qualified
    and trained physiotherapists or hydrotherapists to improve an animal's function in a
    purpose built, and suitably heated hydrotherapy pool or underwater treadmill.

    Benefits of hydrotherapy
    The benefits of hydrotherapy depend very much on how the hydrotherapy treatment is
    carried out. For some dogs simply floating or swimming gently in water can relieve
    pain and inflammation. For others more vigorous exercise is used to increase the use
    of limbs, increase muscle bulk and tone, and strengthen the support for joints.
    Especially after surgery or injury hydrotherapy can allow earlier return to normal use.

    Water can also be used as a means of supporting dogs in a non weight bearing or
    partially weight bearing environment to allow movements that would not be possible
    on land, perhaps because of weakness or injury. This is particularly useful for dogs
    that have spinal problems.

    Hydrotherapy can also increase cardiovascular fitness and help with weight loss.

    Benefits of hydrotherapy can include:
•   Decreased pain perception
•   Decreased pain and inflammation
•   Possible feeling of well being due to release of endorphins
•   Relaxation of muscle tension and/or muscle spasm
•   Reduction of oedema (swelling)
•   Increased range of movement in water helping to ease stiff and arthritic joints
•   Non weight bearing - it is easier and more comfortable to move in water so animals
    often gain confidence
•   Non weight bearing - less joint concussion avoiding further damage after injury or for
    dogs with some form of dysplasia
•   Support for weakened or spinal injury dogs
•   Reduction of frustration for dogs on cage rest or reduced exercise - less likely to be
    'uncontrollable' on land
•   Increased muscle strength
•   Improved muscle patterning and recruitment helping to improve gait patterns
    (reduction in lameness)
•   Improved cardiovascular fitness
•   Potentially earlier return to normal activities - very important for owners of Assistance
    or Working Dogs
•   Slowing of progression of some symptoms of degenerative diseases
    Improved quality of life

    Conditions treated with hydrotherapy
    In general conditions treated with hydrotherapy fall into the following categories:

•   Orthopaedic
•   Neurological
•   Soft tissue injuries
•   Degenerative and medical conditions
    Conditions related to age - either juvenile/developmental or geriatric

    These conditions can include:
•   Arthritis
•   Hip dysplasia
•   Cruciate ligament rupture - either conservative management or post operative
    recovery
•   Patella luxation
•   Elbow dysplasia
•   Degenerative myelopathy (formerly known as CDRM)
•   Spinal injuries including recovery from fractures and IV disc rupture (commonly
    known as a slipped disc)
•   Spondylosis - spinal arthritis
•   Mobility problems related to age
    Obesity control

    Why use a Registered Canine Hydrotherapist?
    It is important that any client has confidence in the therapist treating their dog. By
    choosing to use a Registered Canine Hydrotherapist (RCH) you can be assured that
    the hydrotherapist looking after your dog or cat is trained in hydrotherapy and is
    required to abide by a code of practice and ethics by their professional association.

    Every RCH is listed on the NARCH website enabling you to check that their
    registration is valid as well as providing details on the type and level of training
    completed and areas of competence or expertise.

    A listed RCH has fulfilled the NARCH training requirements for registration (which
    are the highest in the UK) and must keep up to date by completing a further 20 hours
    of Continued Professional Development training each year. Registration with NARCH
    is not an easy option for a canine hydrotherapist.

    RCHs are required to abide by the guidelines and rules set out in the Guide to
    Professional Conduct for Registered Canine Hydrotherapists and must hold public
    liability and professional indemnity insurance.

    Hydrotherapy
    What are the benefits of hydrotherapy?

    The benefits of hydrotherapy depend very much on how the hydrotherapy treatment is
    carried out. For some dogs simply floating or swimming gently in water can relieve
    pain and inflammation. For others more vigorous exercise is used to increase the use
    of limbs, increase muscle bulk and tone, and strengthen support for joints. Especially
    after surgery or injury this can allow earlier return to normal use.

Water can also be used as a means of supporting dogs in a non weight bearing or
partially weight bearing environment to allow movements that would not be possible
on land, perhaps because of weakness or injury. This is particularly useful for dogs
that have spinal problems.

Hydrotherapy can also increase cardiovascular fitness and help with weight loss.

How does hydrotherapy work?

The hydrotherapy pool allows the animal to exercise in a non weight bearing
environment which relieves pressure on joints, reducing pain and encouraging
movement. In the underwater treadmill the water height can be adjusted to precisely
control the amount of weight bearing allowing increases as the animal strengthens or
recovers.

It is difficult to move quickly within water (because of the viscosity or 'stickiness' of
water) so the water has a cushioning or protective quality reducing the risk of injury.
This same quality means that the dog has to work hard to move forward when
swimming and in turn this helps to increase muscle strength and bulk. This is a very
useful property for young dogs that are on restricted exercise, as they can exercise
hard in the water with little risk and use up some of their excess energy.

Within water animals are also subject to hydrostatic pressure and this has the effect of
a gentle pressure bandage on limbs. This can help to reduce swelling and then pain
especially in the lower limbs - very useful for dogs with elbow, stifle, carpal and tarsal
injuries or arthritis.

Do I need my vet to refer me?

Many vets will refer a dog for hydrotherapy as a matter of routine following certain
surgeries or for particular conditions. You are free to contact a hydrotherapy centre
yourself and the centre will then contact your vet for permission for hydrotherapy
treatment. The vet will need to confirm that your animal is fit enough and well enough
for hydrotherapy and provide any additional medical history that is relevant.

Registered Canine Hydrotherapists will never swim an animal without a vet's
permission. This protects you, your dog and other animals visiting hydrotherapy
centre, and ensures that the treatment plan is appropriate for your dog. Expect to be
asked for a lot of information about your dog or cat, particularly on your first visit.

How much will it cost?

Costs vary widely depending on the type of centre, its facilities, and where the centre
is situated. All centres should publish their charges and these should be clear and easy
to understand. As a general guide you can expect to pay between £20.00 and £50.00
per session with a RCH. Dogs that need more assistance or who have behaviour
problems may cost more to be treated.

Many factors influence the length of time your dog will spend in the hydrotherapy
pool or underwater treadmill. These may include the particular injury and/or surgery
carried out, the medical condition, breed, age and level of fitness of the dog. For
example a heart condition or obesity will limit the amount of exercise a dog can
manage when it begins a hydrotherapy program.

How long will I need to continue?

This depends on the reason for hydrotherapy.

As a guide post cruciate surgery recovery would normally be 8 to 12 weeks.

A young dog with hip dysplasia may need to swim for 6 months to 1 year until
skeletally mature. An elderly dog with chronic arthritis may need hydrotherapy twice
a week for 8 weeks, to gain a good improvement, and may then benefit from weekly
or bi-weekly hydrotherapy for the rest of its life.

Will my insurance pay?

It depends on the terms of your insurance policy and how the insurance company
defines hydrotherapy. Some insurance companies limit the number of hydrotherapy
sessions per condition; others will pay up to your insurance limit. Some companies
include hydrotherapy under 'complementary' treatment whilst others have a
hydrotherapy section in the policy.

Call your insurer and ask for clarification of your particular policy. In case of dispute
it is prudent to note the name of the person you spoke to, the date and time of the call
as well as any information given to you.

Do check if you need to get pre-authorisation for hydrotherapy treatment and, if so,
get the insurance company to send you the form immediately.

Check if the insurance company will require a letter of referral for hydrotherapy from
your vet.

How do I know the hydrotherapist is trained?

Check the NARCH List of Registered Canine Hydrotherapists. You can search by post
code, area or hydrotherapists name.

You can also search by hydrotherapy centre name and see a list of Registered Canine
Hydrotherapists that practice at that centre.

The training undertaken by a RCH will be listed under each of their entries on the list.
All RCH's have agreed to meet and maintain the training standards required by

NARCH.

How is an underwater treadmill different from a hydrotherapy pool?

The hydrotherapy pool allows the animal to exercise in a non weight bearing
environment which relieves pressure on joints reducing pain and encouraging
movement. The pool is very useful for encouraging natural movement and motivating
dogs by retrieving or play.

In the underwater treadmill the water height can be adjusted to precisely control the
amount of weight bearing. The degree of weight bearing can be increased as the
animal strengthens or recovers. The speed of the underwater treadmill can also be
changed to achieve the best possible movement of the limbs. The dog can be viewed
from all angles and this is very useful for assessing how it is moving and to make
adjustments to get better quality movement. Re-educating gait or correct limb use is
very important for dogs learning to walk again after spinal problems.

How clean are hydrotherapy pools?

All Registered Canine Hydrotherapists are trained in Pool Water Management. The
pool or underwater treadmill chemical levels are tested several times a day to ensure
that the water is safe and always has sufficient disinfectant properties to protect both
the animals and humans from any risk of infection. Detailed records are kept of
measurements and treatments. Most hydrotherapy pools use chlorine as the
disinfectant chemical, although other chemicals and methods are acceptable. You
should expect to see a spotlessly clean pool with sparkling clear water though
possibly with an amount of fur floating on the top if the last client was a
Newfoundland or large German Shepherd!

Can I swim with my dog?

This will depend on the individual hydrotherapy centre's rules. Some centres with
larger pools allow clients to swim their own dogs for fitness or to be in the water to
help motivate and encourage the dog.

In centres where clients are allowed in the water the swimmer must be over 18 years
old.

Can all dogs swim?

No! Some breeds such as Labradors, Retrievers, Spaniels and Newfoundlands are
bred to be natural swimmers but even so some can be nervous or can take time to get
used to the idea of swimming in a pool. It is important that the first introduction to
swimming is a positive experience.

There are some dogs that have no idea how to swim and these dogs may require close
supervision in the water.

Dogs that are very muscular, such as Staffordshire Bull Terriers, tend not to float as
well as other breeds and have to work much harder to stay on top of the water
however, once they learn to swim they tend to love the experience.

Bracycephalic breeds (those with shortened muzzles such as Boxers, Pugs, Old
English Bulldogs and some Cavalier Spaniels) can struggle to get enough breath when
working hard. These breeds need particular care when they swim or attend
hydrotherapy.

What if my pet doesn't like water?

With sensitive and gentle handling most pets can get over any dislike of water (though
not always). Your hydrotherapist will allow extra time and it could take a few
hydrotherapy sessions for your dog to relax. Some dogs that appear to hate water, and
will walk round puddles and refuse baths and showers, can take to swimming
surprisingly well, especially with praise and reassurance and the hydrotherapist in the
water with them.