Pawsitive Progress: Animals in Rehab

Most physical therapists entered the profession to work with people. That’s why meeting an animal physical therapist can often cause folks to do a double-take. But if you’re an animal lover, get excited: the concept of animals in rehab, either as patients or “providers” has gained wider acceptance and adoption. But to get started, there are a few key steps and regulations that you should be aware of if you plan to treat animals in rehab therapy.

Treating Animals in Rehab 

The most common way for PTs to work with animals is to actually treat injured animals. There are all sorts of reasons why animals wind up needing rehab, but some of the more common diagnoses that animal PTs treat include: 

• Arthritis
• Degenerative joint disease (DJD) or degenerative disc disease (DDD)
• Hip dysplasia
• Tendonitis
• Muscle tone abnormalities
• Nerve injuries
• Vestibular and balance disorders
• Post-operative care

But before you get too excited about working with dogs or horses (the two species most frequently treated in animal rehab), there are a few things to keep in mind.

Know your state’s practice act.

As with any type of care delivery, you must understand your state’s practice act before starting a new animal therapy endeavor. Unfortunately, a majority of states have not specified where animal physical therapy rests within rehab therapists’ scope of practice (although a few have). In many states, veterinarians view human physical therapists delivering animal physical therapy as nothing more than “unlicensed vet assistants,” which can dissuade many PTs from pursuing a career in animal rehab. 

Karen Atlas, PT, MPT, CCRT, is the founder and director of animal rehabilitation at Atlas Rehabilitation for Canines. The Santa Barbara-based canine rehab clinic offers a comprehensive program to treat pooches using manual therapy, hydrotherapy, balance therapy, e-stim, laser therapy, and therapeutic exercise, among other interventions. The team uses an inter-professional, collaborative approach with both onsite and offsite referring veterinarians. Atlas and her canine PT colleagues are based in California—where animal rehab regulations are not yet defined—and they deliver care on a licensed veterinarian’s premises with on-site supervision.

Atlas is involved in quite a bit of advocacy to help move physical therapists into the space of animal rehab, noting “In 73-plus aggregate years of practice, no consumer complaints or disciplinary actions have been taken against a physical therapist in a state that operates under an indirect-supervision model.” This demonstrates how safe the model is for consumers and their pets. Atlas advocates for a move toward indirect supervision models after a referral from a doctor of veterinary medicine (DVM) has been made. This enables PTs to practice without burdensome regulations (for example: mandating that animal therapy services be directly supervised by a veterinarian and only take place in a veterinarian’s office).

Atlas also points out that to work as an animal PT, a therapist needs more than a license. She explains that to become certified and competent, physical therapists must receive training on: 

• Animal behavior,
• Animal handling,
• Anatomy,
• Comparative physiology,
• Biomechanics,
• Pathology,
• Pain management,
• Infectious diseases,
• Musculoskeletal imaging, and
• Much more.

She adds that once an animal PT is certified, they will know “how to detect pain and how to identify red flags for pets who would be better served by other forms of medical treatments at their primary veterinarian.”

Seek out formal education in animal PT.

While certification isn’t technically required as a condition of practicing as an animal PT, it’s strongly recommended for exactly the reasons Atlas mentioned above. The lack of formalized language around animal PT essentially makes it the “Wild West” of rehab. So, you might be able to treat dogs, horses, and other animals without formal training—but why would you? There’s no doubt that formal higher education will make you a more competent, confident practitioner for our furry friends. In many of the states that already have defined language allowing animal PTs to practice with indirect supervision (and after receiving DVM medical clearance/referral), there are minimum educational standards the therapist must first meet to work under those provisions.

Here are the main educational—and continuing education—organizations that provide animal rehab programs for licensed physical therapists:

1. Canine Rehabilitation Institute 

This program offers a canine rehabilitation therapist certification and is open to physical therapists as well as veterinary professionals. 

2. University of Tennessee 

This program offers canine rehab certifications and is open to physical therapists, physical therapist assistants, and occupational therapists—as well as veterinary professionals. 

3. The Animal Rehab Institute

This program offers equine rehab certification options for both PTs, OTs, and PTAs.

4. North Carolina State University in collaboration with Northeast Seminars

This program offers animal rehab certifications and is open to Veterinary Technicians, Veterinarians, PTs, PTAs, and OTs. They also offer equine rehab. 

Don your advocacy cap.

Given the “Wild West” nature of animal PT, you’ll also want to prepare yourself for advocacy. As noted above, most states have no rules on the matter, and veterinarians in some states are working to limit PTs’ scope of practice in the animal world. That’s one of the reasons why you’ll want to consider joining the Animal Rehabilitation Special Interest Group (SIG) in the Orthopaedic section of the APTA. 

It’s also wise to network and connect with other animal PTs in your locale. 

Get creative.

Even if you live in Colorado—which is considered one of the more progressive states in terms of indirect supervision laws for animal PTs—keep in mind that animal PT roles are pretty coveted, and they’re extremely niche. That means you’re unlikely to simply waltz into a canine or equine PT job without doing some prep work. 

No matter where you live, you’ll want to start by doing some shadowing. If there’s an animal PT in your area, see if you can spend a few days with them so you can get a better idea of whether you’d enjoy the work. If your experience is positive, then it may be time to dig a little deeper. 

It’ll also serve you well to have some real-life experience working with dogs (or horses, if you go that route). Logging volunteer hours at an animal shelter or stable can be very helpful. And in a more niche setting, contact your local department of natural resources or a licensed wildlife rehabilitator, to get exposure to injured wildlife.

Animal-Assisted Therapy 

After all this talk about treating animals, you might feel overwhelmed—and maybe a bit discouraged considering the lack of legal definition. Well, I have good news for you: if you’re a rule-follower by nature—and don’t feel comfortable practicing animal PT in states that don’t have defined rules and regulations around care delivery—you still have options! Here are a few:

Hippotherapy

If you’re a horse person, you’ll want to explore hippotherapy. This practice realm involves OTs, PTs, and SLPs using evidence-based practice and clinical reasoning to incorporate horses into patients’ physical therapy care plans. 

The American Hippotherapy Certification Board (AHCB) “endorses the concept of voluntary, periodic certification by examination for all professionals who use hippotherapy in their practice.” AHCB notes that professionals (PT/As, OT/As, and SLPs) who have worked in hippotherapy and meet the eligibility requirements may take the AHCB certification exam. One can also become a board-certified clinical specialist in hippotherapy (this is only open to PTs, OTs, and SLPs).

Inpatient Animal-Assisted Therapy

Not a horse person? There are options for you to work with dogs and cats while treating humans. The main consideration with any pet therapy program is sanitation. If you’d like to develop a pet therapy program at your facility, you’ll want to:

1. become friendly with the infection control team (if applicable), and
2. have a plan in hand for how you’ll build and implement the program—while maintaining the highest standards of infection control.

If pet therapy sounds like your cup of tea, the Latham Foundation for the Promotion of Humane Education has published a comprehensive guidebook to help you get started. 

The Bright Future of Animals in Rehab

The concept of rehab for animals has come a long way in the last 20 years, but there is still room to grow. As with telehealth physical therapy and cash-based physical therapy, many PTs are simply figuring out how to navigate uncharted territory as they go! But, there’s a bright future ahead for animal-loving physical therapists. If you’re willing to advocate for your niche and invest in some credentials, you’ll likely be able to build a career where you blend the best of your favorite worlds.