- Today is the final day of bark & whiskers Creating Heathy, Happy Pets Week 2023, and to close things out, our guest today is licensed physiotherapist and canine rehab therapist Sarah MacKeigan
- Sarah became a licensed physiotherapist for humans, and then made an immediate switch to the field of animal rehabilitation
- Sarah believes every dog deserves the opportunity to lead active and fulfilled lives despite injury/disease and is passionate about empowering pet parents to get their pets moving again both in person and online
Welcome to the final day of bark & whiskers Creating Healthy, Happy Pets Week 2023. This past week, I've focused on the many different aspects of pets' physical, mental, and emotional well-being through interviews with a wide range of experts in nutrition, behavior, enrichment, exercise, and physical rehabilitation.
My final guest is Sarah MacKeigan, a licensed physiotherapist and canine rehab therapist whose website, Upward Dog Rehab & Wellness, is a virtual classroom where pet parents learn different ways to help their dogs achieve optimum health.
Below are some of the highlights of our discussion, but I encourage you to watch the full interview above for much more detail and information.
From Physiotherapist (for Humans) to Animal Rehab Therapist
I'm thrilled today to introduce all of you to small animal physiotherapist Sarah MacKeigan, who runs Upward Dog Rehab & Wellness and the online platform, Living with Dogs with Disabilities. Sarah and I have rehabbed some well-loved dogs together, and I'm grateful she's able to spend some time with us today.
Sarah started as a licensed physiotherapist for humans, so I asked her to explain her decision to spend so much time in school for human physiotherapy, only to almost immediately switch over to animal therapy.
She explained that her dog, Sammie, had a cranial cruciate ligament (CCL) injury, and when she took her for rehab, there was a human physiotherapist mentoring the veterinarian. Sarah thought to herself, "Physios can work with dogs?" And then Sammie's second CCL went down, which is common, and Sarah realized she really wanted be able to rehab her own dog.
"I always wanted to work with animals when I was younger," she explains, "and I just ended up down a different path. Sammie was that pivot point for me. The means to working with dogs was physiotherapy with humans. I treat my pet parents, but I prefer my furry friends.
I flexed my hours so I could take some courses to upgrade and left my job. I sold my house and went back to school with folks who were a lot younger than me to do my Master's of Science in physiotherapy. In Canada we do a master's degree. I became a licensed physiotherapist (PT) and then went on immediately to begin training for my Diploma in Canine Rehabiltation. In the U.S. there's the Canine Rehabilitation Institute and the University of Tenessee Canine Rehab Certificate Program. Canada has a diploma program. Anyway, that was my very intentional path to dogs."
I'm a veterinarian who took a canine rehabilitation course. Vets can become licensed in rehab. But it's a very different thing than spending years and years immersed in the detailed training Sarah has received. It's very different, and I absolutely acknowledge that.
Sometimes You Pick Your Path, Sometimes Your Path Picks You
Sarah doesn't limit herself to treating just "knee and back dogs," as we call them. She's passionate about taking on the really hard cases, such as amputees, paraplegic dogs, challenging neurologic cases, and animals who've endured profound trauma to their bodies. It's not an easy road to travel.
"Sometimes you pick your path and sometimes your path picks you," says Sarah. "My path picked me through my experiences with my own dog, Sammie and the lessons shared by other dogs along my path. But just to back up for a minute, I want to acknowledge that you recognized that physiotherapists, or physical therapists, approach things a little differently. It's really about client-centered care and our approach to clinical reasoning.
We follow what's called a patho-functional diagnosis. Often, your vet will diagnose your dog with a CCL tear or intervertebral disc disease at T11-12 or something along those lines, this is a patho-anatomical diagnosis. As a physiotherapist, the way I look at it is not just the injury but what's happening in the rest of the body, what has contributed to it, how it's impacting mobility and other factors throughout the rest of the body. Maybe there are other injuries, other comorbidities. And then begin the work to restore mobility.
It's also very much a collaborative effort. I always tell pet owners when I talk with them, 'I'm not a drop-off, pickup service. You are part of the process. Your dog is the center of the process. You are an active, empowered pet parent and have a role in your dog's mobility plan and recovery because I spend a small percentage of time with your dog and you spend the rest of the time with your dog. So what you do actually makes a really big difference.
As a physiotherapist, I have I have been trained in manual therapy. A lot of people think of chiropractors, but physiotherapists also do a lot of manual therapy. Again, the caveat is they must be certified and trained to do it, because some people use the word physiotherapy, but they don't necessarily have the training. It's important for pet parents to make sure the person has credentials. I use modalities like laser therapy, acupuncture, muscle stim, and exercise therapy — specific exercises intended to achieve specific results. I also use mobility aids, which I'm going to talk to a bit.
And then there's exercise and education. It's really teaching you how to work with your dog, what to look for, progression, and reassessment. I've met a lot of people who feel their dog is stuck at a certain point in recovery. Part of the problem is the dog hasn't been reassessed. Reassessment is a very important part of progressing a treatment plan and restoring mobility.
Sammie was my heart dog and she did have a number of health and mobility problems and yet, she was incredibly happy. She taught me so much about life, perseverance and adaptability. Something you shared with me back then, Dr. Becker, that I couldn't see yet as a new grad, was that she might have degenerative myelopathy (DM). This was a very emotional time as I learnt about the disease and Sam's future. However, Sam still taught me so much, and I've been blessed to have people like you who have taught and shared with me. Sam lived for almost five years after those initial signs, which is basically unheard of. The average lifespan of a dog with DM is 6-12 months. Eventually she didn't have use of her back legs, but I learned what options were available to slow disease progression and to make sure she still had a good quality of life. These experiences shaped me and that's really what I mean when I say my path chose me.
Sam passed away right before COVID, and then we were locked down. I couldn't treat patients, and at the same time I saw all these people struggling online with all the misinformation out there. So that's when I started the Facebook group Living with Dogs with Disabilities. It was therapy for me. I was able to share a lot of knowledge and bring people on that could help pet parents who were going through challenging times with their dogs."
The Importance of Physical Movement to Maintain Mobility
Most well-loved dogs aren't getting the physical exercise they need to maintain their weight, muscle strength, and resiliency. Their tendons and ligaments aren't as healthy as they should be, which sets them up for lax joint structure, early arthritic changes in the joints, lack of joint fluid, overall pain and inflammation. This situation triggers the downward spiral I see in so many midlife dogs who start to occasionally limp, decide not to go upstairs anymore, or not get on the bed. It doesn't have to be this way.
"One of the challenges is that a lot of people wait until something is very wrong with their pet," says Sarah. "The dog that seems a little bit off is suddenly on three legs, for example. When you see something that's off with your pet, that's when you want to act. It's so much easier to intervene and put a plan in place to restore mobility. Early intervention is critical. I think sometimes pet parents think they're seeing something, but they're not really sure. The typical go-to strategy from their veterinarian is along the lines of 'Here's an anti-inflammatory. Rest your dog for the next week or two and we'll see how he does.'
What happens is that because we haven't retrained the system, we haven't taught the dog to use the leg again, we haven't promoted healing versus just taking away pain, the likelihood of the dog reinjuring the leg is pretty high and probably the other leg, sadly.
So we're trying to address the problem, but it's a negative cycle because we're not introducing the right exercises and the right stressors. Stressors probably sounds like the wrong word, but when tissues heal, we want to increase the load through the tissues based on the stage of healing. Movement is medicine. It's just getting that right movement."
A takeaway here is that if you see your dog limping, or holding a strange posture, or anything similar, take note. And if you see it repeated enough, you should assume things aren't okay. You should contact your veterinarian and/or a physiotherapist. The sooner you get a professional involved, the better.
Obviously, maintaining pets at a lean, healthy weight is important. Good, healthy food is really important. But from a physio perspective, there's a lot more we can be doing to minimize degeneration and potential injury in our dogs and cats.
"Absolutely," Sarah agrees. "There are two approaches. It depends on what your resources are. If possible, have someone do a full mobility assessment. There's so much you can tell just by the way your dog moves, how she stands, how she sits. And a mobility assessment is a lot less expensive than surgery, which could be down the road if we miss something that's going on early. For example there are some breeds, sadly, that are prone to problems like intervertebral disc disease, however, there are things we can do and pet parents can do early to reduce the risk of serious injury."
Sarah explains that turning weekday sedentary dogs into "weekend warriors" is a bad approach because the likelihood they will wind up with an injury is high.
"There are different factors that can make it difficult for us to be active," says Sarah. "But our dogs are a reflection of our lifestyles, so we want to take that into consideration. I think part of the misconception is that people think they must dedicate 30 minutes every single day to exercising their dog because that's how we've scheduled our own exercise. But you don't have to do that with your dog if you can't. Doing something is better than nothing. I encourage people to attach an exercise to an activity their dog is already doing. For example, at breakfast time do an exercise in standing. I wish everybody would teach their dog to stand. It's so much more functional, helping them with balance, body awareness and core control."
Giving Injured Pets the Opportunity to Heal
My hope is that this interview inspires people whose dogs are slowing down, or have had a traumatic injury, that they can help their animals have a functional quality of life. It's up to you to empower yourself to make a plan. To help preserve your pet's remaining quality of life, you want to help him get back in a brand new game, with a brand new plan, with a brand new set of perpetually changing protocols that will allow him to live life differently but still live life.
When a dog or cat is given the opportunity to heal, they take it and literally run with it on wheels. Life is different than it was before, but they go for it. They grab that second chance.
Sarah has developed resources and a support group for humans who have dogs with mobility challenges. I think just having a community of people who love their animals more than anything, dealing with the same stuff is incredibly supportive, along with sharing tips and info and wisdom.
"… I call it online mobility coaching," says Sarah. "There's so much you can learn from a video. I also have a lot of other resources, content and courses online and am launching the 'Dogs That Can' podcast this fall. I really believe every dog deserves the opportunity to live an active and fulfilled life despite injuries/diseases and every pet parent deserves to be empowered and supported to help their dogs."
Sarah does one-to-one mobility coaching online, and she also offers canine rehab in her local community. If you'd like to learn more about Sarah and the services she offers, visit her website, Upward Dog Rehab & Wellness, course platform, or Facebook group, Living with Dogs with Disabilities. And do check out Dogs That Can this fall!