Veterinary Paraprofessionals (physio/chiro/osteo etc)

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 am not, and have never said anything negative about bodyworkers - if you read my post properly, you will see what I said. It's actually really annoying to put time and effort into writing a post like this, to then read a post that makes it very clear that the writer has made no effort to read it properly, or respond to the points raised - just jumped on the opportunity to have a little rant.

It is not 'pandering' to your vet. It is working within the law (Veterinary Surgeons Act 1966).

It's up to you who you use, my points were that a; it's against the law for bodyworkers to work without veterinary referral, and b; are people who operate this way the sort of people you want touching your horse.
 
Calcyle said:
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.
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Hopefully the lack of regulation and some standardisation in practice will be addressed by the "Review of Minor Procedures" initiative commenced by DEFRA which kicked off April 2013 and is being run by the Veterinary Physiotherapy professional associations (ASSVAP, ACPAT, IAAT and IRVAP). There is also a sub-group, MAST (massage & soft tissue therapists), which covers the bodyworkers etc.

However, I won't hold my breath for anything changing this year, BUT it is a step in the right direction!

A couple of points though. Firstly, most vets will currently give known qualified individuals blanket permission to treat their clients and work on a 'report back/call me if in doubt' basis. Personally, if I were a practitioner I would never rely on the client asking permission from the vet on my behalf even if they were prepared to sign something to that effect; could be an interesting one for the insurers if it ever came to it!

Yes, there are some charlatans out there and hopefully the above initiative will make it more difficult, if not impossible, for them to practice. On the flip side of the coin though, there are some talented individuals who have a good knowledge and grounding who are not members of ACPAT, which is the organisation that seems to get lauded the most on this forum. Noone however is infallible, not even members of ACPAT; and I am aware of one who has missed obvious hind limb lameness, did not recommend veterinary involvement and focussed on the back 'being out' to the client. There are good and bad both in and out of the existing professional bodies is what I am getting at and it will be a difficult situation to resolve, ensuring the interests of all parties are met and protected.
 
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The thing is, the last few times my vets have been unable to properly diagnose my horses and my Osteo was able to diagnose and advise on a way forward. (wasn't even something he could possibly treat) no wonder my loyalty has changed.
having said that when they come in bleeding ofcourse vet would be the first port of call.
 
I am a qualified body worker, although not practicing atm. I am rubbish, because I almost always recommend a lameness work up first (even though I always have vet permission). People don't want to hear that their horse might be lame anymore than they want to hear its their riding/saddle/training 'regime' that's to blame.

The reason I know to get a lameness work up is because my old horse had physio, from a very experienced, well regarded and qualified ACPAT physio, with vet permission, for a couple of years and never picked up on the fact he was bilaterally lame behind (because she never wanted to see him trotted up/worked, because she was so experienced). Until he went hopping lame due to stifle OCD.If it had been caught before it would have had a better prognosis. The physio helped the symptoms but not the cause.

Anyway, I spent several years training in two modalities which I now use on my own horses.Oh, and my EDT is also a vet.
 
Kikke said:
The thing is, the last few times my vets have been unable to properly diagnose my horses and my Osteo was able to diagnose and advise on a way forward. (wasn't even something he could possibly treat) no wonder my loyalty has changed.
having said that when they come in bleeding ofcourse vet would be the first port of call.
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Then you have been very unlucky in your choice of vet. Yes, bodyworkers have their place . . . and those who are properly accredited have received extensive training . . . but, wrt lameness in particular, I would always get a vet to look at my horse before getting out an osteo/physio/chiro to see to him for fear of doing more harm than good. That said, for lameness, I rely on a vet who has a specialism in lameness/mechanics. If Pops had a problem with, say, his eyes - I'd be wanting a referral to a vet who specialised in that.

P

P.S. Actually, for lameness, the first person I contact is my farrier - it won't do my horse any harm to have his feet checked to rule things like abscesses/corns in or out before I contact my vet . . .
 
This conversation actually cropped up at our yard the other day as a couple of the liveries have a mctimoney person out every month to see their horses and they have left their advert in the tea room. When i was looking at options for dexter, ironically they are not registered with the mctimoney body hence why the owners have got round vet permission. Their horse is still lame but because 'the vet is expensive' they decided to skip that step.
Thankfully for dexter, the vet checked him and was given the all clear bar muscle tightness.The physio is workng wonders on him and should be ready for riding by the end of july.
I've never understood why ppl think they're taking a shortcut by not at least speaking to their vet and diving straight in blind especially when they're clearly lame!
 
Goldenstar said:
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 .
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This. My physio/EDT/osteo don't speak to my vet before each appointment (got an initial signature saying that they and permission to treat the horse by owner referral) , but they are not coming to see a lame horse, or horse with a clinical problem. I use them for regular check ups, and for muscle assessments and help with planning training. My instructor works very closely with my physio reports. So I guess in a way it is more of a sports' physio usage.

If my horse was lame, or I suspected any pain or unusual stiffness, then I'd be getting the vet first, and physio would be referred to either alongside or instead of the veterinary work.
 
I think people aren't really understanding my point - for which i apologise, as I obviously didn't put it across very clearly.

I am not having a pop at bodyworkers, and I'm not saying that they are not the best person for the job when a horse has muscular stiffness/tension that needs releasing - I absolutely agree that the job they do is vital, and that there are some very good ones around.

What interests me is that very few people seem to understand that it is against the law for someone who is not a vet to put a finger on your horse without your vets referral (which can be a simple phone call, costing nothing but the price of the call). Without making contact with your vet before starting work on the horse, bodyworkers are acting unlawfully. Whether you personally agree or not is irrelevant - the law is in place, and has been since 1966. If you are of the opinion that you don't need a vets referral, and book someone to come and treat your horse - it's your prerogative to do so. The industry, as someone said earlier, is chaotically under-regulated, and whilst there are so many (probably perfectly competent) people not following the law re veterinary referral - it makes it impossible to police, and opens the door wide open to all the charlatans and crooks who are able to go around ruining horses by manipulating them, without a real clue what they are doing. With the best will in the world, it's easy to be taken in by a bone-cruncher in a branded truck who breezes in, says "X,X and X are wrong - let me fix that".

It needs sorting out, and if that means that it becomes the norm that people can only contact a bodyworker through their vet, than that's absolutely fine by me. It wouldn't be too difficult for vets to hold a register of qualified people in the area, so owners still had choices. They would just be competent, safe, qualified and insured choices - I don't see that as such a bad thing.
 
Auslander said:
I think people aren't really understanding my point - for which i apologise, as I obviously didn't put it across very clearly.

I am not having a pop at bodyworkers, and I'm not saying that they are not the best person for the job when a horse has muscular stiffness/tension that needs releasing - I absolutely agree that the job they do is vital, and that there are some very good ones around.

What interests me is that very few people seem to understand that it is against the law for someone who is not a vet to put a finger on your horse without your vets referral (which can be a simple phone call, costing nothing but the price of the call). Without making contact with your vet before starting work on the horse, bodyworkers are acting unlawfully. Whether you personally agree or not is irrelevant - the law is in place, and has been since 1966. If you are of the opinion that you don't need a vets referral, and book someone to come and treat your horse - it's your prerogative to do so. The industry, as someone said earlier, is chaotically under-regulated, and whilst there are so many (probably perfectly competent) people not following the law re veterinary referral - it makes it impossible to police, and opens the door wide open to all the charlatans and crooks who are able to go around ruining horses by manipulating them, without a real clue what they are doing. With the best will in the world, it's easy to be taken in by a bone-cruncher in a branded truck who breezes in, says "X,X and X are wrong - let me fix that".

It needs sorting out, and if that means that it becomes the norm that people can only contact a bodyworker through their vet, than that's absolutely fine by me. It wouldn't be too difficult for vets to hold a register of qualified people in the area, so owners still had choices. They would just be competent, safe, qualified and insured choices - I don't see that as such a bad thing.
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Actually, you were crystal clear . . . people are just not bothering to read and digest before posting (in some cases) - or have the attitude that it doesn't actually matter (in other cases).

P
 
gunnergundog said:
Hopefully the lack of regulation and some standardisation in practice will be addressed by the "Review of Minor Procedures" initiative commenced by DEFRA which kicked off April 2013 and is being run by the Veterinary Physiotherapy professional associations (ASSVAP, ACPAT, IAAT and IRVAP). There is also a sub-group, MAST (massage & soft tissue therapists), which covers the bodyworkers etc.

However, I won't hold my breath for anything changing this year, BUT it is a step in the right direction!

A couple of points though. Firstly, most vets will currently give known qualified individuals blanket permission to treat their clients and work on a 'report back/call me if in doubt' basis. Personally, if I were a practitioner I would never rely on the client asking permission from the vet on my behalf even if they were prepared to sign something to that effect; could be an interesting one for the insurers if it ever came to it!

Yes, there are some charlatans out there and hopefully the above initiative will make it more difficult, if not impossible, for them to practice. On the flip side of the coin though, there are some talented individuals who have a good knowledge and grounding who are not members of ACPAT, which is the organisation that seems to get lauded the most on this forum. Noone however is infallible, not even members of ACPAT; and I am aware of one who has missed obvious hind limb lameness, did not recommend veterinary involvement and focussed on the back 'being out' to the client. There are good and bad both in and out of the existing professional bodies is what I am getting at and it will be a difficult situation to resolve, ensuring the interests of all parties are met and protected.
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Fab post! Yes, next meeting is scheduled for September, they started last January and no end is in sight yet (I am a member of one of the listed organisations)

I now call the vet before every appointment (unless part of a course already covered), more often then not it just involves the receptionist having a quick word, but then I have peace of mind.

Personally I think if it's not a rehab case, then if the therapist isn't getting improvements after a couple of sessions they should refer back to the vet, and not persist with ineffective methods. One of the hardest parts of the job is knowing to say when to stop, but it sometimes must be done.

And on a point from another poster- only a vet can give you a diagnosis, legally. Again, vet surgeons act 1966.
 
PolarSkye said:
Actually, you were crystal clear . . . people are just not bothering to read and digest before posting (in some cases) - or have the attitude that it doesn't actually matter (in other cases).

P
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Agreed. Clear as the light of day to me :rolleyes3:
 
I think you were really clear, I am really interested in the debate it has sparked though despite it being a little off point.

Fascinating how badly regulated it is really considering the damage things can cause (the amount of 'pelvis out' that I hear, including from a dressage judge saying I ought to have ***** out because Arnie was unlevel, it must be his pelvis!)

That said I have used some fantastic professionals, and I know they are professionals because they won't come out without getting permission from my vet :)
 
Sorry, I think it was me not getting my point across properly rather than you!!

I completely agree that VS Act is as it is, and that is the law. Any Physio/body worker should be getting veterinary permission at least the first time they touch any specific horse. I was more responding to the 'just get the vet' comments that came after, and the idea of getting a Physio out before a vet.

I am very vet cynical. I went to vet school, and work with vets all the time, and with the majority of general practice vets (specialists are another kettle of fish) they are TRAINED to deliver a diagnosis with confidence, even when they are not. (I've spent too much time with medical students and young doctors too - and that's why I'm now terrified of hospitals!)

Up where we are, there are no real specialist vets. The closest specialists to us are two hours drive away. So you end up dealing with 'big fish in a small pond' type vets, who think that Physio is a waste of time because they aren't trained in it, and it drives me mad. There are a lot of things my Physio does that my vet cannot, on a sub clinical level. My vet can only tell there is something off if my horse is actually lame!!! (And if horse is lame I usually just ask for a referral to a specialist as the local vets have misdiagnosed multiple times for me before...)

Personally, I think saying get the vet first before the Physio etc is a bit narrow minded. I think regular routine Physio can help prevent a lameness that would need veterinary investigation! However I do agree that, regardless of the law, it is just good practice for vet and Physio to be speaking to each other, and for vet to be aware of any Physio work whilst Physio aware of case history. In case of actual lameness, people are mad if they get a body worker first, but I would definitely call out my Physio before my vet on many occasions, and after an initial permission from the vet, and with no clinical problems emerging, my Physio does not need to get veterinary permission for every outing to my horse. (Legally, if it is the same 'issue' ie none in this case, then the original
Permission still stands).

I hope that makes more sense? I wasn't disagreeing over the law and the lack of respect for it, and illegal diagnosis, more the comments about calling the vet first I disagreed with.

Also, to the comments about 'pelvis being out' - it is an actual thing, you know. My human doctor and Physio have diagnosed me with the same thing. My hip muscles and lower back muscles spasm, and tighten to the point where my right hip and pelvis sit half an inch higher than the left. This was due to a bad injury I had last year. I get regular Physio for this. So your horse's pelvis can be 'out' as a genuine diagnosis - it does NOT mean dislocated, it is shorthand for 'out of alignment' meaning muscular spasm pulls one side of the pelvis out of alignment with the other. Interestingly, my horse developed the same thing on the same side as mine, a few months after me. We now receive the same treatment (muscles loosened and pelvis physically pulled back down) but from two different physios!!
 
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My vet knows I have physio to mine every 3 ish months and agrees. When they first saw the issue they wanted x rays scans and all sorts. Recommended physio to make her comfortable through the process and the physio fixed it (junior vet) so I told them I would be using physio regularly and gave them her name for my file. I remind them at jab time annually but I don't ask them for permission or pay a call out and consultancy fee each time before I have a professional who I have known for years come to treat my horses. Vet senior partner seems happy enough, but then he's a fab vet and a very practical individual.
 
There are lots of posters coming on saying "I don't see why I should get vet permission before every visit" or "my physio is part of training schedule so diesn't need the vet" & I don't think anybody has argued otherwise. What we are trying to say is that a decent therapist will check with the vet whether there is anything they need to be aware of before they start & will recommend the vet if a therapy isn't working.
If anybody hasn't come across therapists who don't bother to find out history or who don't just keep on with the same ineffective therapies or owners who will get a unqualified "back person" out to a clearly lame horse with no questions asked you have led a far more sheltered life than me.
 
Actually just realised that most people who come on here ARE using therapists appropriately & that the people I am thinking of are more likely to go on the sort of facebook page where the response to any badly put together, half starved scrap is "aw hun heez gawjus. U gunna jump him hi?"
 
Spotsrock said:
My vet knows I have physio to mine every 3 ish months and agrees. When they first saw the issue they wanted x rays scans and all sorts. Recommended physio to make her comfortable through the process and the physio fixed it (junior vet) so I told them I would be using physio regularly and gave them her name for my file. I remind them at jab time annually but I don't ask them for permission or pay a call out and consultancy fee each time before I have a professional who I have known for years come to treat my horses. Vet senior partner seems happy enough, but then he's a fab vet and a very practical individual.
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Thats how its supposed to be done. Your vet knows you are using them, and therefore they have approval. I've not said anywhere that you need a vet visit every time your horse is seen by a physio. In fact, I've said several times that a quick phone call which costs nothing is considered to be perfectly acceptable!
 
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