There are more and more options out there for our patients in the way of braces, orthotics and assistive devices. They can
provide much needed help during or after rehab, surgical recovery, as an alternative to surgery and our geriatric patients.
Braces and other forms of support can provide comfort, protection or improve confidence for rehab patients. The braces, wraps
and supports typically come in multiple sizes although they are not custom made or custom fit to a specific patient. A number
of companies make neoprene wraps or braces tailored to different areas of the body. Common ones are carpal or hocks braces
or wraps to provide extra support. These can be considered for patients with osteoarthritis (OA) associated with those joints
or mild hyperextension, varus or valgus issues. They will not provide enough support for moderate to severe problems. DogLeggs
http://www.DogLeggs.com/) makes an elbow wrap for dogs with hygromas or similar issues along with one for amputees. They are even willing to do custum
work if they feel they can benefit the patient. Thera-Paw (
http://www.Therapaw.com/) makes combination boot/wrap that aide dogs that have problems with dragging or knuckling of the paw. They make both a front
and hindlimb 'Dorsi-Flex Assist' although technically it should be a 'Dorsi-Extend Assist' for the front.
Orthotics are used to support, straighten or improve the function of a body part. Prosthetics are used to replace a portion
of a missing limb. Custom orthotics and prosthetics is an emerging field in veterinary medicine although it has been around
for a long time in the human field. There are several human orthotists that have expanded their interests to include veterinary
patients on a commercial level. In addition, there may be someone on a local level that may be interested on a case by case
basis in your area. A thorough evaluation of the patient and disease condition should be performed prior to selecting orthotics
since they typically cost several hundred dollars. Typically a cast or mold of the area needing support is made and shipped
to the orthotist who then makes the orthotic based on the cast. Good communication with the orthotist is important. Since
the orthotics are made from a static cast yet placed on a moving patient there may be the need for modifications to the product.
The patient should gradually wear the orthotic for longer periods of time each day similar to breaking in a new pair of shoes.
The device can be worn for an extended period of time after the break-in period and adjustments are made. This is typically
during daytime hours or during high activity periods. They are not intended to be worn 24-7. Both the patient and the orthotic
should be assessed for wear points, pressure points or other surprises. It is not uncommon for the device to be returned
to the orthotist for modifications several times before getting the 'right fit'.
Slings are a common device for use in the hospital, rehab facility or at home. The slings can be used to support the rear
or front end. They may simply slip under the patient, fasten around or have leg/arm holes to keep them from slipping or shifting.
The straps should be long enough so the person using the sling is not bent over or straining their back.
A harness is another device that can be used in the hospital, rehab facility or at home. Several companies produce harnesses
with low-profile handles that the patient can wear comfortably for extended periods of time that allow the rehabber or client
to assist the pet in rising. These are especially useful for geriatric patients with osteoarthritis and some degree of neurologic
deficits that struggle to get up for walks or have trouble on slicker surfaces. They are also nice for neurologic patients
or orthopedic patients in the recovery stage.
Boots or booties can be used to increase a pets traction on slippery surfaces, increase proprioceptive awareness and protect
feet of neurologic patients that are prone to soft tissue injury and nail wear from scuffing or dragging. The boots typically
have a rubber sole to aid in traction and minimize wear and tear. Most have a Velcro strap to secure them around the pet's
foot but some use straps or elastic bands similar to tube socks. Some are very functional but some are strictly for the cuteness
factor alone without much function. Pawz (
http://www.pawzdogboots.com/) makes a disposable, biodegradable, reusable, waterproof boot that is easy to use and low cost. These are nice because they
come in multipacks and are low cost so if you lose one or wear through it you can easily grab another. They are good option
if the pet is not expected to need boots for an extended period of time.
Certain types of flooring, especially tile, hardwood and linoleum, can be a problem at home for some pets. Carpet runners
with nonslip backing, yoga mats and rubber floor mats can be used to improve traction. Antislip tape or stair treads can be
used to improve traction on stairs or other areas around the house.
Some pets love to be up on the couch or bed with their owner. Some disease processes like osteoarthritis make it harder for
the pet to jump up on the furniture like they used to do. When it is not contraindicated due to the disease process, such
as a postoperative fracture repair, pet stairs can be used to make getting on and off the furniture easier. There are many
companies that can be found on the internet that make pet stairs in a variety of materials, price, size and quality. Along
the same lines, a lot of pets need help getting in and out of the car. Many companies also make a variety of ramps to aid
pets and their owners. If you really want to get carried away you can get the 2011 Honda Element with a Dog Friendly Package
that includes among other things a stowable ramp and dog bed.
Bedding is another important thing for rehab patients especially the geriatric and neurologic patients that may spend more
time lying down. Lying on hard surfaces can increase the risk of pressure sores and make arthritic joints stiffer. One or
more good quality orthopedic beds are important especially if the pet likes to spend time in different places around the house.