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Understanding and managing arthritis

Abstract

No-one is more surprised than Hannah Capon at her decision to leave clinical practice to help arthritic dogs. This is how it happened

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I Wanted to be a vet from a very young age, except for a brief wobble when I thought air hostessing looked more appealing!

Many of us fought for our place at vet school. We gave up after-school hangouts to study. The summer holidays we spent seeing practice. And we pushed ourselves to grab any opportunity to work with animals.

Maybe our passion and drive isn’t down to the degree, but the people that we train ourselves to become. Whatever the case, a veterinary degree allows us to pursue new goals and directions. I knew I wanted to influence change and leave something positive in my wake, but I didn’t know what.

Canine Arthritis Management (CAM) came about by accident really. After 10 years of being a small animal vet, I was looking to add to my skills base and wanted to explore physiotherapy and rehabilitation.

I felt that as a profession we were weak at detecting anything more than joint pain to explain lameness, lumping everything under the umbrella of ‘soft tissue injury’ and prescribing a course of NSAIDs.

But, being single and dependent on my salary, I was not in a position to pursue a physiotherapy degree, so I looked at courses that would give me further insight into soft tissue work.

I had heard about Galen Myotherapy from a receptionist I was working with. She had been blown away by the results she was getting with her dog, and as the founder Julia Robertson didn’t live far away in Sussex, I persuaded her to let me watch her work.

Learning to listen to animals

I won’t lie. Having been taught the importance of evidence-based veterinary medicine and knowing that complementary therapies struggle to fulfil these requirements, I was pretty cynical that anything would ever compete with the power of a formulated analgesic. But the next few months blew that preconception out of the water, and I started to learn how to read and listen to dogs in a way that has changed my whole career, and has led me to taking on my biggest challenge so far.

‘I started to learn how to read and listen to dogs in a way that has changed my whole career’

Through Galen Myotherapy I have learnt to identify signs of chronic pain, target problematic areas and influence positive soft tissue changes through manual therapy.

I started combining it with a veterinary approach to managing arthritis and I got results that I hadn’t imagined were possible. It also left me feeling I was finally working with the dogs I was seeing and not being a ‘white coat’ on the other side of the table.

I started a one-to-one home arthritis clinic in addition to my daily vet work. Working in owner’s homes, where dogs were more relaxed, my approach to managing canine arthritis came together.

I found dogs were much more compliant when they were examined away from the consultation room. It enabled me to listen to owners and question them, and I realised that what we vets preach in the consulting room does not make it home with them.

Over the next few years I obtained a better insight to owners’ understanding, motivations, and expectations. I learnt what was possible through combining veterinary training with hands-on therapy, and I was also visiting owners’ homes and witnessing their lifestyle and animal management and the negative impact it could have on debilitated dogs.

The uptake of my one-to-one service was slow because owners and vets were unable to identify subtle signs of chronic pain. They also failed to understand the importance of early detection of arthritis and the urgency to act to control pain and improve mobility.

I tried bringing my new understanding into the consultation room, but I would perpetually run late as I just couldn’t fit everything into a 15-minute appointment. It was frustrating.

Teaching owners how dogs express chronic pain, what arthritis is and how it progresses, as well as the numerous ways to manage it, clients become empowered, motivated and compliant.

I felt compelled to help people to help their pets, so in 2016 I began to build an open access website, which was launched in April 2017 (www.caninearthritis.co.uk). Initially, it contained a few pages covering simple steps to manage osteoarthritis, but it soon grew into 100 pages of honest, experienced advice, written in language that owners could understand.

The motivation for ‘Canine Arthritis Management’ (CAM) was to help educate owners about how animals express chronic pain and explain that arthritis is not inevitable and not just part of ageing. The phrase ‘he is just getting old’ is not acceptable until we are sure it is not pain causing the symptoms.

I left employed veterinary work in October 2016, with the intention of trying to change the way we manage arthritis in companion animals.

I wanted to offer a reliable, evidence-based online platform for owners, one that vets could refer them to. And I wanted to create a community for owners of dogs that have this debilitating disease as I have witnessed first hand how emotionally draining this disease is.

Seeing how arthritis is managed in people by Arthritis Research UK and Arthritis Foundation, I have been inspired to create similar resources for managing canine (and soon feline) arthritis.

Funding

There’s no doubt about it, it’s not a good business strategy to give your information away! I continue to fund CAM through locum work and night duties. But I’m forever the optimist that it will soon self support through public and veterinary support of the services and resources we now supply. It also has an active Facebook community and a Twitter and Instagram presence.

We have developed materials for practice waiting rooms, such as business cards with the online addresses, postcards to stimulate thought in the owner before a consultation and posters highlighting the prevalence of osteoarthritis.

Last month my 14-year-old border collie and I spent eight days walking 100 miles along the South Downs way to raise awareness of the ways in which animals express pain. I want to encourage owners to question their dog’s behaviour change, rather than believing it is just ‘slowing down’ or ‘getting old’. By identifying these are potentially signs of pain, I hope they will seek veterinary advice that may open up treatment options for their dog.

We are launching our newsletter and an arthritis booklet to improve owner compliance and case management, and I am tweaking the final touches of the Canine Arthritis Foundation online forum. We offer a practice-based CPD package to help the veterinary teams formulate a new approach to managing the condition

Growing team

We are now a team of five. Gwen Covey Crump is our specialist veterinary adviser; Kirsty Cavill RVN, is our social media go-to and online adviser; Daisy Tipping is our office wizard and Danny Knight produces our materials. We aim to be a reliable support system for small animal vets who struggle to provide owners with enough advice to manage this long-term disease. The feedback we have had so far is great. The platform that we’ve created and the message we are sharing has been well received.

CAM will grow and could do so quicker with veterinary support. We are always looking for contributors and collaborators, as well as financial support to continue our work. If you feel inspired to contact us, e-mail: daisy@caninearthritis.co.uk.

Looking back, would I have thought that my veterinary degree would lead me to attempt to create a global online platform to help owners manage their dog’s arthritis? Probably not, but it proves what wonderful options are open to us.

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