The Ultimate Guide to Canine Rehabilitation

Did you ever wonder how you can combine your love for animals with your passion for PT? Canine rehabilitation is a fast growing field, and you, as a licensed PT or PTA, can also be a part of it. Are you curious about how to work with canines? How to successfully transition from working with humans?

I've written a guide to take you from ground zero. In this ebook, you’ll find information on what canine rehabilitation (also called canine physical therapy) is, how to get there, and all those fun financial considerations you need to know.

You can also download this Ultimate Guide by clicking here! There's some great illustrations, and you'll be able to read offline whenever you want 🐶

What is canine rehabilitation?

Canine physical therapy, also commonly referred to as canine rehabilitation, is a field of veterinary medicine that promotes the management and treatment of injuries, pathologies, and functional impairments within the canine population.

Although often performed with canines, other species can also benefit from rehabilitation.

As a matter of fact, the field of veterinary rehabilitation first started with equines in the 1960s and 1970s, and continued to grow in the following decades with the advancement of veterinary care for racehorses. Professionals in the veterinary community started to realize in the 1990s that the same concepts applied to smaller animals, and at that point, established the field of canine rehabilitation.

Just like in human physical therapy, the goal of canine rehabilitation is to achieve the highest level of function, independence, and quality of life possible for the patient.

 A certified canine rehabilitation clinician must be well versed in the field and trained to perform a thorough evaluation of the patient, including assessment of gait, mobility and functional activities, strength, flexibility, endurance, joint range of motion, and soft tissue mobility.

The evaluation should also contain a complete review of the patient’s medical history, including detailed education for the pet owner about any pathology, long-term outcomes, treatment options, plan of care and goals. Educating the pet owner will be vital for a successful rehab program and it is what will set you apart from anyone else working in the field.

You will also assess the home and community environment in respect to how it might affect the patient’s functional status, and once again educate the pet owner on how to modify the environment or how to use any assistant devices. (Notice the trend in client education and don’t think that you won’t be dealing with humans anymore!)

Then, based on the results of the evaluation, a canine rehabilitation clinician will develop a detailed plan of care designed specifically for that patient, including short and long-term goals established with the pet owner. The purpose of this individualized plan of care will be to achieve the highest level of function, independence, and quality of life possible for that patient.

Unfortunately, with the exponential growth in popularity in the field, some myths and misconceptions also started to gain traction.

Read this guide offline by downloading the ebook!

Canine rehabilitation is more than just underwater treadmills

One of the main misconceptions about the field is that canine rehabilitation largely consists of laser therapy and underwater treadmill. Unfortunately, any veterinary clinic can purchase a laser unit or an underwater treadmill and claim to provide canine rehabilitation, even without a certified canine rehab specialist on staff. As physical therapists we know that although those can be useful options of modalities of treatment, they do not define what we do.

The veterinary practice act in every state allows any veterinarian, even those not certified in canine rehabilitation, to practice in the field. Therefore, as it grew in popularity, some companies saw it as an opportunity to take advantage of the lack of knowledge from the public and started to advertise “canine rehabilitation” as a service provided after purchasing a laser unit or an underwater treadmill.

Fortunately, these cases are the exception rather than the rule, and most clinics have a certified veterinary rehabilitation clinician on site.

At the same time, it is vital for a pet owner to look for a certified canine rehabilitation veterinarian or physical therapist when looking for those services for their pets.

These myths and misconceptions inspired me to create “TheK9PT” as a way to reach out directly to the public and educate them on canine rehabilitation. It started as blog, but it has now grown into my own small business providing canine rehabilitation services in Chicago.

Laser therapy and underwater treadmill can be an important component of a successful rehabilitation program; however, many other treatment modalities and techniques have to be taken into account as well when developing a plan of care.

What defines a good canine PT?

Just like in human PT, in my opinion, the “bread and butter” of a successful program is therapeutic exercises. After all, "movement is medicine," and it significantly affects the whole body. However, the clinician needs to be highly skilled on how and when to progress the exercise program; otherwise, it becomes a “one size fits all” approach.

It is also vital to include the pet owner in the program with a home exercise program and to educate the client on a variety of issues, including compliance with the program, prognosis, and how to better help the patient with daily activities at home and in the community.

Essentially, canine physical therapy consists mainly of:

  • Therapeutic exercises
  • Client (owner) education
  • The aforementioned underwater treadmill and laser
  • Therapeutic ultrasound
  • Transcutaneous electrical stimulation (TENS)
  • Neuromuscular electrical stimulation (NMES)
  • Joint ROM
  • Muscle stretching
  • Thermotherapy
  • Acupuncture and dry needling
  • Manual therapy

Such manual therapy techniques might include joint mobilization, joint traction, trigger point therapy, and myofascial release.

It is my strong belief that the greatest asset of a successful canine rehabilitation practitioner is their knowledge in the field, combined with problem-solving skills to properly develop and progress a successful plan of care. Such plan of care should primarily focus on client education, therapeutic exercises (along with a home exercise program), and manual therapy techniques.

With that in mind, that is why I strongly believe that PTs are primed to thrive in this field. Our doctorate degree in physical therapy has taught us all these skills and more! Then, once we pair those skills and knowledge with veterinary anatomy and physiology, we become essential for the field of canine rehab.

Who can do canine PT?

The eligibility to attend the certification courses vary from both programs currently available. Both programs, according to their website, accept veterinarians, physical therapists, and veterinary technicians. In addition, the program at the University of Tennessee also accepts physical therapy assistants and occupational therapists.

The program at the University of Tennessee, according to their website, also allows students of those professions to attend the courses. However, personally this is not something I would recommend, considering the amount of studying we already have to endure during PT school. You would also benefit from some years of experience in human physical therapy first before transitioning into canine rehabilitation.

Also, be aware that your ability to practice canine PT can greatly vary based on where you live and your state’s Physical Therapy Practice Act. The same applies to other countries, which have different rules and regulations regarding the involvement of physical therapists in this field. Below are some links that can be helpful in this matter.

The good and bad of canine PT

When it comes to canine rehabilitation, I believe that the list of pros vastly outweigh the list of cons. However, there are certainly some things to keep in mind before transitioning into this field:

  1. Time commitment: this is not a weekend course! Regardless of which program you choose, you will spend 200+ hours on it, including online lectures, classroom lectures and hands-on labs, exams, and a 40 hour internship at the end.
  2. Financial commitment: it will also cost you significantly more compared to a weekend course. The cost can vary between the programs, but you can plan on spending something between $6,000-$10,000 including course fees, traveling, and lodging.
  3. Job outlook: job opportunities can be limited depending on where you intend to practice. As previously mentioned, your state practice act can limit your ability to treat animals, and as a growing field, job opportunities tend to be more available in large metropolitan areas. However, it could also be a great opportunity to start your own business, as it is a new field with significant demand.
  4. Salary: veterinary medicine in general does not create as much revenue as human medicine does, and this is reflected in lower salaries for staff positions when compared to human medicine. However, the positive side is that veterinary medicine is a cash business, meaning you don’t have to deal with insurance constrictions and can achieve financial success as a business owner.

Day-to-day of a canine PT

The best thing about your day-to-day as a canine PT is that you get to see dogs all day! (And some cats too, at times.)

However, don’t think that you will be done dealing with humans. As a matter of fact, you will be building up relationship with clients everyday, and communication is key so they know what to expect and to buy into your program. I have actually had to improve my communication skills because now I have to speak on behalf of my patients to my clients, instead of directly to my patients.

You will also get to treat a variety of patients in the same day, including orthopedic injuries, post-op patients, neurological conditions, amputees, geriatrics, athletes, etc. The population will vary depending on which setting you work, but you will certainly not be seeing the same diagnosis over and over again. (Hooray to no more knee replacements!)

As previously mentioned, you will also be able to implement a variety of different treatment techniques and modalities throughout the day. As you can imagine, these are all one-on-one treatment sessions since these patients require your attention 100% of the time during their time with you. (No more documenting while treating!)

Speaking of documentation, it will be significantly less daunting since you won’t have to follow insurance and medicare guidelines any longer. So even though you can’t document while treating, it will be fairly easy for you to get caught up with it during a break or at the end of the day.

Download the Ultimate Guide to Canine Rehabilitation as an ebook, complete with illustrations!

How to become a canine PT

There are currently 2 programs in the United States offering a certification in canine rehabilitation. The Canine Rehabilitation Institute (CRI) offers a certification as a CCRT (Certified Canine Rehabilitation Therapist) to PTs and DVMs, and a CCRA (Certified Canine Rehabilitation Assistant) to veterinary technicians and, in some instances, PTAs. (I contacted CRI and PTAs can take their course if they have a letter of employment from a DVM or PT in the field). The University of Tennessee (UoT) offers a certification as a CCRP (Certified Canine Rehabilitation Practitioner) and is open DVMs, PTs, veterinary technicians, PTAs, OTs, as well as students in one of those professions. Both schools also offer a variety of continuing education courses for those in the field.

The major difference between these programs is the amount of hands-on experience and in-class lectures that you get.

At CRI, some of the content is in the form of online lectures but you will spend a total of 13 days (or about 104 hours) doing in-class lectures and hands-on labs. Those 13 days are broken down into 3 different modules taken separately, each with a take home exam at the end.

At UoT, you will complete 5 modules, with 2 of them online and another 2 in-person, and a fifth elective course that can be either in-person or online followed by a final exam at the end of those modules. The in-person labs add up to a total of 36.75 hours of hands-on experience, not counting the elective course.

Both programs culminate with a 40-hour externship at an outside clinic, similar to clinical rotations in PT school.

The benefit of CRI’s program is the emphasis on hands-on experience, whereas at UoT you have better time flexibility to complete the program and a lower cost due to an emphasis on online lectures.

Personally, I chose to get certified with CRI because I have always been a very hands-on learner during my PT education. Furthermore, I tend to lose focus watching too many lectures online. It was a bigger time and financial commitment compared to UoT, but it was totally worth it. (disclaimer: Francisco now works for CRI as a teaching assistant and consultant)

Here is a chart for a quick comparison between both programs:

From my experience, both as a student and as faculty, you would benefit more from the certification courses if you already have at least 1-2 years of experience as a human PT. Not to say that you can’t go straight into it once graduating with your DPT, but it is important to first develop some of your skills as a PT such as manual treatments, exercise progression, evaluation, assessment, and most importantly your communication skills, including listening and selling yourself as someone who can solve their problem.

You will get on-the-job training during your internship at the end of the program; however, 40 hours goes by really fast and you learn a lot during that week. I always recommend to PTs to learn more about dog handling and behavior since we are not familiar with those areas. That way you can focus on clinical skills during the internship.

Personally, I volunteered at a local dog rescue as a dog walker to get used to handling different sizes and shapes of dogs. It was also nice to be able to help those dogs. It developed into a great way to network with local rescues and other volunteers, who are often pet owners and potential future clients. In addition to that, I read up on canine behavior and body language, and spent some time shadowing a dog trainer during her dog obedience classes.

You will certainly get better at reading canine body language as you spend more time with your patients. In fact, it is VITAL for us to develop those skills!

First, that is how you will learn to manage your patients—from handling and touching, to progressing exercises and knowing if what you are doing is causing any discomfort. Second, you do not want to get bitten by a patient! Contrary to what you might think, your patients will “speak” to you and let them know how they feel—just not in words. So reading those signs and knowing when to back off will be essential.

It is also always a good idea to shadow or talk to someone in this field. First, to learn more about it before making a financial and time commitment to it. Second, to observe how they do things and starting gaining some knowledge in treatments and handling techniques. Finally, to NETWORK! (Do you see the network pattern already?)

Can you actually make a living doing this?

There are a variety of different approaches you can take when transitioning into getting a job in canine rehabilitation. There is no right or wrong way to go about it, but a lot will depend on your personal finances (i.e. student loan debt), ability to relocate, state legislation regarding the practice of animal rehab, personality and goals.

As previously mentioned, when comparing apples to apples (staff position in human PT vs staff position in canine PT) you will get paid less in the veterinary field. That is probably the biggest drawback from this otherwise wonderful field. However, there are a few options to decrease the financial burden:

  1. Part time positions: more often than not, PTs tend to transition into this field by accepting a part-time position at a veterinary clinic. Usually this means working something like 1-2 days a week while honing your skills and developing a clientele. That allows you to continue working in human PT 4-5 days a week, while maintaining a paycheck that is comfortable to you.
  2. Contractor/PRN positions: if you decide to go full-time canine rehab, keeping a PRN position in human PT can also add some extra income at the end of the month. It can be a weekend at SNF or acute setting, or home health as a contractor for an agency.
  3. Side hustles: so many options here! However, I know a few therapists that do dog sitting as a side business for extra income. They tend to focus on special needs pets (post-op, neurological cases, geriatrics, etc) that need extra care. It is usually really hard for pet owners to find qualified pet sitters in these scenarios, and you can easily charge at least $60-$75/night. That means you can quickly add-up to an extra $500-$1000+ at the end of the month. (Side note: this could be a good gig for SPTs as well.)
  4. Extra skills: you could develop some added skills outside of patient care that could be valuable to your employer, thus adding some extra revenue in addition to treating patients. For example, social media and digital marketing. A lot of clinics either outsource these services (paying quite a bit to do that) or lack the knowledge to successfully implement them. What if you were to learn more about those areas and offer them those services? That will increase your value to them and thus increase how much they pay you.
  5. Extra benefits: depending on your employer, you could have access to benefits that could save you some money as well. For example, if you work at a veterinary clinic you will likely have access to veterinary care at cost, which can be a huge benefit if you have one or more pets. You would also have access to some medications and supplements at wholesale price.

Personally, I chose to go with option number 2. Upon finishing my certification in canine rehab, my wife and I were looking to relocate as she had just finished her degree. I got offered a position at a holistic veterinary clinic in Chicago that focuses on rehabilitation and integrative veterinary medicine (i.e. acupuncture, etc). I was working there 35-40 hours/week, and also took a contractor position for a home health agency, which was perfect because it paid a very reasonable amount per visit, and it allowed me to schedule those patients around my own schedule.

I stayed in that position for about 2 years, and during that time launched my website/blog. TheK9PT was created as a way to help educate the public about canine rehab, but also to help guide other PTs and SPTs interested in this field. As time progressed, I started to learn more about marketing and entrepreneurship, and then decided to go full-on as a small business owner.

In October of 2017, TheK9PT went from a blog/website to my own business providing home health services in canine PT. For me it was a perfect transition because I live in a large metropolitan area that values convenience, I was already used to driving around the city for my human patients, and that kept my overhead costs super low.

It has been A LOT of work getting my business off the ground and building up relationships with veterinarians and other professionals in the pet industry. However, the benefits from this hard work is already paying off after a few short months. Business is steadily growing and yielding financial success already (even more than I could make as a human PT!!!).

Now, I have made one of my life goals to get more PTs into this field by leading by example and paving the way so you can also do what you love without having to sacrifice yourself financially.

Like I said before, this is a brand new field with a high demand in many locations. The sky can be the limit for those who are willing to put in the work and build their own brand and business! As PTs, we are primed to thrive in this setting due to our highly trained manual skills and thought process. That allows us to keep overhead costs low as we build our business, without having to take a huge loan for larger pieces of equipment like an underwater treadmill.

Want the Ultimate Guide to Canine Rehabilitation as an ebook? Download it here!

Frequently Asked Questions

Do you have to work with a DVM on-site?

That will vary depending on your state’s practice act. Some states allow us to work under the referral of a DVM, much like we are used to in human PT without Direct Access. However, some states require a direct supervision where the DVM needs to be in the same building for a PT to treat an animal.

How much can I realistically expect to earn as salary?

A comparable staff position in canine PT vs human PT will pay significantly less. The amount will of course vary a lot depending on geographical location, cost of living, clinics’ business model, etc. However, I have seen PTs in the field usually earning something between $20/hr to $30/hr, with the majority in between $20-$25. These values would be for a full-time position with benefits, and should be greater if you don’t receive benefits and/or work part-time or as a contractor.

What are some job searching resources in this field?

Networking will be a major source for job searching! There are also a couple of forums online (facebook group, yahoo group) that contain job postings. Also, both CRI and UoT have a dedicated page in their website dedicated to job postings.

Any recommended resources such as books, journals, professional associations, meetings, etc?

I highly recommend joining the Animal Rehab Special Interest Group (ARSIG) within the Orthopedic Section of the APTA. It is free for Orthopedic Section members! You can also join the ARSIG’s lecture at the Combined Sections Meeting to learn more. In addition, you can join the American Association of Rehabilitation Veterinarians (AARV) 100% free as a student and at a fairly reasonable price as a PT or PTA. There are also a variety of textbooks about canine rehab, including the following:

I have also created a facebook group (Canine Physical Therapists) dedicated to therapists and students interested in learning more about this field!

Is this field only for canines or can we work with felines or other animals?

We call it canine PT because the majority of our patients will be dogs; however, you can certainly work with other species such as felines and equines. As a matter of fact, UoT offers a certification in equine rehabilitation as well.

How do I find out more about the state of canine PT in my state?

The first step will be to familiarize yourself with your state practice acts as it relate to canine PT by looking both at your Physical Therapy and Veterinary Practice Acts. It would also be a good idea to find a PT in your state that practices canine rehab and contact them—they may not be too familiar with the legislation and politics behind it, but it would also be a good way to network.

Finally, get involved both in a national and state level! Join the Animal Rehab Special Interest Group within the Orthopedic Section of the APTA, start attending your chapter meetings and ask them about any plans regarding animal rehab, and if needed even form a group of PT/PTA/SPTs in your state interested in this field. This is a brand new field and state legislation is taking place as you read this, so it is vital for us to get involved in this process to make our voices heard and drive the profession forward.

Is there a timeline to complete the certification courses?

Not that I am aware; however, it is recommended to finish them within a year or so as to have some continuity in your education.

Do I have to relocate to complete my certification?

Absolutely not! Both certification programs were designed for long-distance learning. However, you will probably save money in traveling and lodging if you happen to live close to where the courses are offered.

I am a DPT student and I am really interested in this field. How do I learn more about it? Can I do a clinical rotation in canine rehab?

I am not aware of any available clinical rotations, but that doesn’t mean that they don’t exist. If that is something you would want to pursue, then I would recommend discussing it with your program’s Director of Clinical Education and reaching out to potential clinics. Another option would be to shadow a PT at a clinic, just like you did as an undergraduate student applying for PT school. Also, as previously mentioned, you can join professional organizations like the ARSIG and AARV. Finally, join my facebook group created for physical therapy professionals and students interested in this field!!!

Do you recommend getting certified as soon as I have graduated with my DPT degree?

I actually recommend working as a human PT for 1-2 years before starting your certification. The first couple of years will be vital for your overall education and transition into a full-time clinician, and I would recommend focusing on other aspects during that time such as clinical and personal development, communication skills, and patient care.

How does it work with pet health insurance? Do insurance companies dictate reimbursement rates like in human PT?

No, they do not! Not to say that it might not change in the future, but I doubt that veterinarians would allow for that to happen. This is a 100% cash based system, with the client paying you directly and then filling a claim with the insurance company to get reimbursed afterwards.

What is the future outlook of this field? Where do you see it in the next decades?

I personally see this field continuing to grow exponentially in the next decades! There are approximately 145 million household pets in the United States alone, and a tiny fraction of those pets currently have access to services like canine rehab. Even in major urban areas, where this field has grown the most in the last decade, there are still plenty of opportunities. In addition, millennial pet parents tend to care for their pet like they do for their children (or should I say “we,” as I am a millennial who fits that category), and will go above and beyond to do what is best for their pet.

In addition, look at the growth within the pet health insurance business in the last few years. According to the most recent data (end of 2016) from the North American Pet Health Insurance Association, 1.6 million pets are insured in the US (out of an estimated 145M household pets—1.1%), corresponding to a 940M market (21% growth compared to 2015)!

However, as previously mentioned, as the field grows more legislation will need to be updated to reflect that growth and to make sure that PTs continue to be allowed to treat animals. Changing that legislation is a long process, but it all starts with support from your local and state chapters of the APTA. I really cannot stress this enough, but PLEASE GET INVOLVED in this process! You will be helping shape-up a whole new profession and leaving a legacy for future PTs.

Author: Francisco Maia, PT, DPT, CCRT

Link: https://covalentcareers.com/resources/canine-rehabilitation-ultimate-guide/

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