Veterinary Paraprofessionals (physio/chiro/osteo etc)

Auslander

Auslander

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It's something that has been bothering me a lot recently - the amount of posts about bodyworkers of all varieties, and how many people are recommending that people go straight to one, instead of a vet.

I am not in any way denigrating the abilities of any bodyworker to identify and fix a problem. We all know that they can, and do. However, what bothers me is the degree of lack of awareness amongst owners about how these paraprofessionals should work in order to stay within the law.

Basically - only a vet can legally diagnose a problem and devise a treatment plan for an animal. There are no loopholes, there is no way of getting past the fact. Only a vet can legally diagnose. Once a diagnosis is made, they can refer the treatment to a paraprofessional, and they can agree to a paraprofessional carrying out bodywork, but if the bodyworker has not at the very least had a conversation with the vet - they are not operating within the law. Quite apart from the legal aspect - they can't see inside a horse - if they're working on a horse with an existing problem, they may be able to feel localised heat/swelling/tenderness, but without access to veterinary history, including x-rays/scans, they are essentially going in blind.

I personally would not use anyone who agreed to come and look at my horse without first asking for my vet's contact details. The way i see it, someone who has done invested time and energy into becoming a qualified paraprofessional is going to want to work within the law - and in partnership with vets - why wouldn't they? People who don't work that way are far more likely to be under/unqualified, and not the sort of people that I personally would want within a mile of my horses.

Incidentally - the terms Veterinary Physiotherapist and Equine/Animal Physiotherapist aren't protected by law, so anyone can call themselves one of the above. There are so many people out there with no qualifications, who may (or may not) have done a short course/online course, and then set themselves up as physios. I wouldn't want my horse manipulated by someone who had done 5 hours training in equine massage - but there are people out there doing just that. I find that scary!
 
Personally I regularly use alternative therapy providers such as osteo/Physio without a veterinary referral. HOWEVER, only in sub clinical cases, ie a trigger point appearing in muscles, or for regular sports massage. I don't use one on a lame or obviously in-pain animal without having at least discussed with my vet over the phone.

I work in equine healthcare myself (though not as a therapist of any sort) so well know the Veterinary Surgeons Act and it's effects. I wouldn't use someone who did not at least ask for my vet's permission to treat.

Also, if my Physio (who regularly sees my horse, more in a 'watch and work these muscle groups, try these exercises' kind of way) picks up non something clinical it is sent straight to my vet for investigation, as a real pro should be.

But for a sub clinic problem there's no way I'd have my vet out first - just becomes bureaucratic!!
 
absolutely agree with you, it never ceases to amaze me how many people will use a 'back person' and be perfectly happy for them to quite forcefully manipulate their horse! there is one such person local to me who does a weekly session at the local EC, just turn up and he will miraculously right your horses wonky pelvis, because every horse pony has one allegedly according to these type of people! I wonder how they insure themselves, under what guise, if indeed they have insurance?!
 
The whole thing makes me cringe. As soon as I read 'my horse appears unlevel/has developed sudden behavioural issues, so I have called the 'back person' out to try and see if anything is wrong', my stomach turns. Call a bloody vet!
 
Also agree. I'm constantly surprised by the number of people who use EDT's, back people, saddlers and hoof care trimmers that have very little or no, training. It's easy to check if people have the appropriate level of training and vets usually have a list of local specialists anyway.
Why would any sane person say- 'I can recommend my dentist to you, don't think he's qualified but he only charges £20.'
I don't care if he charges 10p, he's not coming near my horse with a rasp.

BEVA and the government have recently done a survey asking horse owners about the qualifications of the people they use in order to see how welfare can be improved. I'm surprised it wasn't done years ago.
 
after an fb friend got duped into having her beloved horse pts by a man passing himself off as a vet , who in fact was not a vet just a sick git, i have been extra careful about who i have out to my horses. i even checked my farrier was registered before i used him which few years ago i just wouldn't have considered i needed to do.
 
If a horse is showing signs of pain or altered behaviour the first port of call should always be a vet it freaks me out a bit that people will advise someone on here to get a 'chiro ' or similar to a horse they have never seen belonging to someone they do not know it's potentially dangerous advice as well as illegal .
 
Ibblebibble said:
after an fb friend got duped into having her beloved horse pts by a man passing himself off as a vet , who in fact was not a vet just a sick git, i have been extra careful about who i have out to my horses. i even checked my farrier was registered before i used him which few years ago i just wouldn't have considered i needed to do.
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God almighty.
 
The physio/osteo I use will only do so on referral from your vet - and will only treat for the condition for which you've been referred. If it's a separate issue they ask for a second referral. Possibly it could be considered a money spinner, but actually I'm happy with it.
 
My vet and physio know each other very well, and work together a lot - so my original referral stands. If the physio wants to do something different, she'll speak to the vet, and she reports back whenever she sees him. I feel very comfortable with this level of communication between them
 
This thread is timely . . . someone I know discovered her horse was lame at the end of last week . . . not tracking up behind/reluctant to go forward. She rested her over the weekend and then got the "back man" out today . . . he manipulated the horse for 10 minutes, "diagnosed" her with "rolling stifle" and told owner how to work her through it . . . I was gobsmacked.

P

P.S. Anyone know what a "rolling" stifle is? I'm assuming we're talking about a luxating patella?
 
PolarSkye said:
This thread is timely . . . someone I know discovered her horse was lame at the end of last week . . . not tracking up behind/reluctant to go forward. She rested her over the weekend and then got the "back man" out today . . . he manipulated the horse for 10 minutes, "diagnosed" her with "rolling stifle" and told owner how to work her through it . . . I was gobsmacked.

P

P.S. Anyone know what a "rolling" stifle is? I'm assuming we're talking about a luxating patella?
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That must be a new one, it is usually "it's pelvis is out" .

In response to the OP it was on my mind to do a similar thread, we both responded recently with much the same views, I also hate the term " back person" which is used for so many therapists, if they are qualified then they should be operating under their qualifications not known as a back person, dealing with backs is only a part of the work they do, a good physio, osteo etc will look at the whole horse before treating, many seem to home in on just part, treat that take the money and leave with no follow up to see how the horse has responded, or not.
 
be positive said:
That must be a new one, it is usually "it's pelvis is out" .

In response to the OP it was on my mind to do a similar thread, we both responded recently with much the same views, I also hate the term " back person" which is used for so many therapists, if they are qualified then they should be operating under their qualifications not known as a back person, dealing with backs is only a part of the work they do, a good physio, osteo etc will look at the whole horse before treating, many seem to home in on just part, treat that take the money and leave with no follow up to see how the horse has responded, or not.
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. . . interesting you should say that, when owner asked "back man" when he should come back to see the mare, his answer was . . . "whenever . . . " . . .

Sigh.

P
 
PolarSkye said:
. . . interesting you should say that, when owner asked "back man" when he should come back to see the mare, his answer was . . . "whenever . . . " . . .

Sigh.

P
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If they are doing the job properly they need to come back to check all is well, if they know the horse and owner then maybe they can leave it for the owner to judge but this is something my physio rarely does if the horse has shown a real problem and it is not just a routine check up with a few tweaks.

The person you know has had a lame horse treated which is exactly what Auslander started this thread for, they should not be diagnosing or treating lame horses without it being seen by a vet first, the fact they rested it prior to treatment may mean it has recovered anyway or that it was not so bad when treated but could flare up again at any time.
The fact that it has not been seen by a vet will also mean any treatment that may be required could have to be funded by the owners as the insurance company could, quite rightly, refuse to pay out if any harm has been done by the back person.
 
I couldn't agree more - particularly on the qualification front - some of them are terrifyingly unqualified (and even some of the qualified ones terrifyingly poorly educated in relevant fields).
 
be positive said:
If they are doing the job properly they need to come back to check all is well, if they know the horse and owner then maybe they can leave it for the owner to judge but this is something my physio rarely does if the horse has shown a real problem and it is not just a routine check up with a few tweaks.

The person you know has had a lame horse treated which is exactly what Auslander started this thread for, they should not be diagnosing or treating lame horses without it being seen by a vet first, the fact they rested it prior to treatment may mean it has recovered anyway or that it was not so bad when treated but could flare up again at any time.
The fact that it has not been seen by a vet will also mean any treatment that may be required could have to be funded by the owners as the insurance company could, quite rightly, refuse to pay out if any harm has been done by the back person.
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Yup . . . and this is why I was gobsmacked and why I said this thread is timely. I was shaking my head in disbelief. I would have said something but, sadly, it would have been dismissed and I would have been thought over-protective.

P
 
Someone I know had a horse that was on off lame, she got a "back lady" out. Got the usual "pelvis is out". Horse was on off lame for months. Every time same thing - back lady & "pelvis out". When she finally got the Vet out the horse was bilaterally lame due to severely damaged tendons on both back legs, the damage was by that time irrepairable & the horse ended up being pts.
 
hairycob said:
Someone I know had a horse that was on off lame, she got a "back lady" out. Got the usual "pelvis is out". Horse was on off lame for months. Every time same thing - back lady & "pelvis out". When she finally got the Vet out the horse was bilaterally lame due to severely damaged tendons on both back legs, the damage was by that time irrepairable & the horse ended up being pts.
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My physio has plenty of similar stories, the horse that was treated for a year before the vet was called in, physio went as well to assist, it had really bad KS but the owner had been strung the usual line the pelvis is out, it had been treated every month with no improvement by the back person before eventually the vet was called in, it was pts. Another had injured itself in a trailer, I think it had actually broken a bone in it's neck but the back person kept going saying they could fix it!!!
 
This thread sounds so negative of alternative therapy providers!!! A good veterinary physiotherapist is a fantastic tool, and they can advise on training programmes and provide exercises for strengthening weaker muscle groups that can really help with training. They can also pick up on early stage muscle tightening that vets cannot (I regularly work with fantastic, very top vets who will turn away non-tendinous soft tissue damage as they can't do much, whereas a Physio can).

However I use an ACPAT professional, and it is proper physiotherapy rather than massage or manipulation. I agree qualifications etc should be checked, and there are a lot of unqualified randoms out there used instead of seeking veterinary treatment, however I think there IS a time for using a Physio before or instead of a vet.
 
I don't think it is being negative about true professionals it is the ones working under the radar that are the issue, they do not work alongside vets, will not have permission to treat and never refer back if the horse fails to respond to whatever treatment they have done.

The two cases I mentioned were both being treated for months before a vet was called in, my physio works closely with the vet so went as well only to find the horses had been undergoing treatment for undiagnosed problems with no improvement yet the owners were being told that they would get better if treatment continued, sadly they did not, there are many good therapists but if every less able one has a horse that does not respond yet they keep going how many horses are suffering needlessly.
 
I use a ACPAT physio too , it's a huge advantage that they can do the rider as well as the horse .
Mine has vet permission to see my horses at time time she then sends a report to the vets and speaks to the vet if she thinks it necessary .
I also think because they have that NHS training they are very good at working in a group with other professionals .
 
be positive said:
I don't think it is being negative about true professionals it is the ones working under the radar that are the issue, they do not work alongside vets, will not have permission to treat and never refer back if the horse fails to respond to whatever treatment they have done.

The two cases I mentioned were both being treated for months before a vet was called in, my physio works closely with the vet so went as well only to find the horses had been undergoing treatment for undiagnosed problems with no improvement yet the owners were being told that they would get better if treatment continued, sadly they did not, there are many good therapists but if every less able one has a horse that does not respond yet they keep going how many horses are suffering needlessly.
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This.

I have no issue with alternative therapies . . . I DO have an issue with charlatans who rock up to a yard with a crochet hook and a great line in patter who convince people they have "treated" their horse.

I am taking my boy barefoot . . . how's that for "alternative" . . . ?

P
 
But surely your qualified physio at least checks with the Vet whether there is anything they need to be aware of? It's the "cheap & cheerful", no questions asked "back person" that is the real problem & there are far too many of them around. I have seen one treat a horse with a badly & recently bowed tendon & advise that it is walked for a week & then back to full work including cantering & jumping. They didn't even ask which vet the owner used. The vet had advised that the horse be retired as the bowed tendon was due to recurrent breakdowns. (not the same example I used earlier either). Guess who the owner listened to & then moaned that the horse was "naughty".
 
Physiotherapist is a protected term (you must be registered with the CSP or ACPAT) which you can only do by qualifying with a degree.

I am equally horrified by people who do this, the only time my physio sees my horse without the vet first is for a check up (and this is still with permission).

There is a particular professional near me that everyone uses and I can't bear it!
 
I maintain I will have who ever I want to see my horse with or without my vets " permission" . I see the vet as another professional that helps look after my horse. I would not ask the vet about getting the saddler!? All the people who deal with my horses are highly trained and can and have worked together. If my horse has a foot abscess why would I call out the vet when my highly skilled, trained and experienced farrier can do it, no he can not diagnose it but he can treat it, at a fraction of the price.. Everyone and every professional has there place. The way some people on this forum go on about chiropractors, tarring them all with the same brush, as if it is a fake profession, I can say after my car accident I needed treatment and it really helped. My horse also benefits from his treatment, it is clear to see. My chiro is also a fully qualified vet and worked at my vets. It is about choosing the correct professonals and using them appropriately rather then pandering to your vet,
Some of those young vets that have turned up to treat my horses have looked clueless, like the one girl who would not even touch Ffins teeth without sedating him, he only put his head up as she approached him, all costs more!
 
hairycob said:
But surely your qualified physio at least checks with the Vet whether there is anything they need to be aware of? It's the "cheap & cheerful", no questions asked "back person" that is the real problem & there are far too many of them around. I have seen one treat a horse with a badly & recently bowed tendon & advise that it is walked for a week & then back to full work including cantering & jumping. They didn't even ask which vet the owner used. The vet had advised that the horse be retired as the bowed tendon was due to recurrent breakdowns. (not the same example I used earlier either). Guess who the owner listened to & then moaned that the horse was "naughty".
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No my physio does not speak to the vet before she sees the horses ( unless of course we are treating a lame horse ) there would be no point because the vet will not have seen the horse .
The physio always sends a report after and will ring the vet if she feels it necessary .
My physio won't arrive and find a lame horse not to blow my own trumpet but I am too experienced for that.
The physio unless we are treating an injury is doing a different job to the vet keeping the horses muscles right imputing into the work plans with ideas for exercises which we do ridden or lunged .
 
Sukistokes2 said:
I maintain I will have who ever I want to see my horse with or without my vets " permission" . I see the vet as another professional that helps look after my horse. I would not ask the vet about getting the saddler!? All the people who deal with my horses are highly trained and can and have worked together. If my horse has a foot abscess why would I call out the vet when my highly skilled, trained and experienced farrier can do it, no he can not diagnose it but he can treat it, at a fraction of the price.. Everyone and every professional has there place. The way some people on this forum go on about chiropractors, tarring them all with the same brush, as if it is a fake profession, I can say after my car accident I needed treatment and it really helped. My horse also benefits from his treatment, it is clear to see. My chiro is also a fully qualified vet and worked at my vets. It is about choosing the correct professonals and using them appropriately rather then pandering to your vet,
Some of those young vets that have turned up to treat my horses have looked clueless, like the one girl who would not even touch Ffins teeth without sedating him, he only put his head up as she approached him, all costs more!
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I don't think anyone suggested that owners should rely on a vet referral for every single procedure . . . farrier, dentist, etc. . . . however, given the complex musculo/skeletal structure of a horse, it makes sense to have any practitioner working on the actual framework of a horse including the horse's vet to avoid doing something contraindicated. There may well be times when a (qualified and licensed) physio/chiro/osteo picks something up in a horse that a vet hasn't seen yet . . . in which case the owner can get the vet out to do further diagnostics . . . no'one is suggesting that this should be "vet first" . . . but treating horses properly should be about all the practitioners (including farriers and dentists) working togther.

My vet and my farrier talk regularly about patients they have in common - that seems sensible to me. My vet has also recommended that my boy see a chiro for stiffness caused by lack of work/turnout due to his most recent injury . . . I am very happy to have both practitioners talk to each other so that the chiro can help us all secure the very best outcome for Pops.

P
 
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I'm lucky in as much as my son is a BEVA qualified EDT so obviously does all the horses teeth. I do use a chiropractor, my usual vet is aware and the the chiropractor is a fully qualified vet. I have also on occassions used an ACPAT physio and she always insists the vet is told before she sees a horse - I thought this was seen as correct professional etiquette. Sadly I think often those that do not ask if the vet has been informed are the ones who are often not fully qualified and seem to think they can cure any ailment. That said, I do know of a bodyworker with some qualifications who told a client there was no point in getting a vet out because the horse in question was only intermittently lame
 
Auslander said:
It's something that has been bothering me a lot recently - the amount of posts about bodyworkers of all varieties, and how many people are recommending that people go straight to one, instead of a vet.

I am not in any way denigrating the abilities of any bodyworker to identify and fix a problem. We all know that they can, and do. However, what bothers me is the degree of lack of awareness amongst owners about how these paraprofessionals should work in order to stay within the law.

Basically - only a vet can legally diagnose a problem and devise a treatment plan for an animal. There are no loopholes, there is no way of getting past the fact. Only a vet can legally diagnose. Once a diagnosis is made, they can refer the treatment to a paraprofessional, and they can agree to a paraprofessional carrying out bodywork, but if the bodyworker has not at the very least had a conversation with the vet - they are not operating within the law. Quite apart from the legal aspect - they can't see inside a horse - if they're working on a horse with an existing problem, they may be able to feel localised heat/swelling/tenderness, but without access to veterinary history, including x-rays/scans, they are essentially going in blind.

I personally would not use anyone who agreed to come and look at my horse without first asking for my vet's contact details. The way i see it, someone who has done invested time and energy into becoming a qualified paraprofessional is going to want to work within the law - and in partnership with vets - why wouldn't they? People who don't work that way are far more likely to be under/unqualified, and not the sort of people that I personally would want within a mile of my horses.

Incidentally - the terms Veterinary Physiotherapist and Equine/Animal Physiotherapist aren't protected by law, so anyone can call themselves one of the above. There are so many people out there with no qualifications, who may (or may not) have done a short course/online course, and then set themselves up as physios. I wouldn't want my horse manipulated by someone who had done 5 hours training in equine massage - but there are people out there doing just that. I find that scary!
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Well said. As one of these paraprofessionals, I wholeheartedly agree with you. I despair of the people who contact me going 'well, I know there's an issue, but I wanted to do everything I could before getting the vet involved', or even better are the ones who contact me and aren't even registered with a vet in the first place.

I also talk very openly about the lack of industry regulation, and the qualifications, professional membership and insurance that I hold. Though I must say that never once has a vet asked me about it.



Shall read the rest of the thread now!
 
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