O and P Almanac — September 2012
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Gone To The Dogs
Lia K. Dangelico

VETERINARY ORTHOTICS AND PROSTHETICS IS A GROWING INDUSTRY—MOSTLY DUE TO THE DEMAND FOR CANINE ORTHOTICS. IS IT RIGHT FOR YOUR BUSINESS?

You’ve probably noticed that pets, especially dogs, have experienced a status upgrade in recent years. The traditional family pet many of us grew up with—the loyal and hardworking Old Yeller or the adventurous farmhand Lassie—has been replaced by pets that are primped and pampered by their owners.

With more than 77 million dogs belonging to more than 43 million owners in the United States, dogs and other pets are no longer just companions; they are often considered a beloved member of the American family. Pet owners are willing to go above and beyond to care for their four-legged friends.

Enter veterinary orthotics and prosthetics (V-OP). In its recent study, “Pet Health: Products and Services,” the Freedonia Group reports spending on pet care is projected to increase by 7.2 percent to $21.5 billion by 2014. While pet health care is undoubtedly a growing industry, is it the right move for your practice? O&P Almanac recently talked to several V-OP professionals to find out.

Expanding Animal Care

Most O&P professionals spend time working on animals in training and early on in their careers, and many are taught that animals can operate just fine on three legs. While that may be true, it’s also true that an existence on three legs ordinarily leads to limited mobility, limb breakdown, and severe pain issues. Over the past decade, further exploration into those issues and the evolution of specialized veterinary care has shown that orthotic and prosthetic solutions can improve the length and quality of life for injured and amputee animals.

The veterinary industry in the United States is composed of a multitude of disciplines, as well as a large number of referral centers that offer physical therapy, surgery, dentistry, neurology, and more to a wide range of animals, from pigs to cows to pet rabbits. For most V-OP professionals, this is where their involvement begins. According to Jim Alaimo, CPO, co-owner and founder of animal orthotic and prosthetic care facility My Pet’s Brace, in Morgantown, Pennsylvania, 50 percent of the referrals he receives comes from specialized referral centers and their surgeons; the other half comes from general practice veterinarians.

Many pet owners turn to orthotics and prosthetics as a more affordable or feasible alternative to expensive or risky surgeries. While one might think cost is the most noted deterrent keeping an owner from choosing pricey surgery for a pet, according to research by the American Pet Products Association, Americans will spend an estimated $52.87 billion on their pets in 2012, with $13.59 billion going toward medical care. Most often, an owner will turn to O&P because the animal has been deemed unfit for surgery due to its age or a severe medical condition.

Ten or 15 years ago, sick and injured pets were often euthanized because no other alternatives were available, but V-OP provides a second chance at life— and a high-quality one at that.

“Families are willing to do whatever it takes in order to help their dog live as long as they can,” says Alaimo. “Dogs are living much longer than they used to because they are getting the specialized care that they never had before.”

(Almost) Strictly Canine

For Alaimo and his partner Mark Hardin, who handles the business side of their company, less-than-desirable circumstances led to an opportunity to “do something fun” in the world of V-OP.

After their previous employer downsized their division, the duo was out of work and wondering where life would take them next. Both lifelong dog lovers, the partners decided to do a little research, and their findings showed that the number of pets in American households was growing, with 25 percent of families owning more than one. From there, they noticed a real need was emerging for quality, specialized animal care—more specifically, canine care.

Started 18 months ago by Alaimo and his partner, My Pet’s Brace is one of just three businesses in the United States that provides orthotic and prosthetic strictly to animals. Ninety-nine percent of the company’s business is treating dogs with injuries or limb loss, and Alaimo’s beloved dog Strider is not only the company mascot but is listed as chairman of the board on the company website.

Jeff Collins, CPO, a lower-limb amputee, was drawn into the world of animal O&P when a veterinarian wanted to perform surgery on his beloved black Labrador Stash for a partial cranial cruciate ligament (CCL) tear. Between jobs at the time, Collins didn’t have the $2,500 necessary for the surgery, so he worked to fabricate a knee orthosis for Stash instead. The project propelled him to research and develop a plan to start his own business, K-9 Orthotics & Prosthetics, based out of Nova Scotia, Canada.

Getting Down to Business

Alaimo and Collins were clear about the logistics of their businesses and how they make them work. From inception to opening their doors for the very first time, their companies were founded on extensive research within the industry, a solid business plan, and a bit of hope. After their businesses were fully operational, Alaimo and Collins readily identified need-to-know information for those considering the field.

Assuming his business would be 50 percent orthotics and 50 percent prosthetics, Alaimo says he was surprised to find the work was far less balanced than that.

“When you get into animal O&P, you learn very quickly that it’s not really a prosthetics business,” he says. “It’s an orthotics business—that’s where the real need is.”

Despite the fact that “prosthetics” is in the name—and often gets most of the attention and fanfare—it’s important to note that this is essentially a canine orthotics business. And while the industry is growing by the day, going into business is “never a sure bet,” says Collins.

Adding that there are no shortcuts at the canine level, Collins stresses the importance of knowing that “you’re going to charge nearly a fraction of the price you would pay for a human application in comparison to the canine applications,” so it will be a cheaper process—but only in cost to the client. “Finding a balance between quality materials and effective designs while pricing accordingly varies in the market place,” says Collins. “I would rather be known for quality than cheapness.”

Whether starting out in V-OP, transitioning into it, or adopting it into your practice, it is essential to first make sure you have the room and the hours to take it on. To provide the most comprehensive, ethical care, animal services should take place either at a separate location or during designated hours, separate from human care. Adding on to existing buildings or incorporating an after-hours schedule are options for those who seek to do both.

But there is a crucial person to the process who is outside the V-OP clinic: the veterinarian. In an effort to operate their business just like a typical human facility, Alaimo and his partner decided early on they would involve a veterinarian in the decision-making process and require a prescription for every device they provide.

“We are not veterinarians trained to diagnose these injuries, so we wanted to make sure that we keep the veterinarian involved so we can provide what the dog really needs,” says Alaimo.

But, warns Collins, that relationship is “not as straightforward as you think.” As with most things in business, there are the inherent politics involved in the process of working alongside veterinarians.

“There are some vets that just don’t believe in orthotics at all and won’t refer clients; however, there are more and more sport medicine and rehabilitation specialist vets exploring the orthotic and prosthetic options available to their patients,” he says. “So there are some academia and political issues to be worked out there between the veterinary practice and the O&P practice.”

Compared to the world of human care that often is rife with reimbursement roadblocks, V-OP professionals find animal care can be a refreshing departure.

“In this field, when you provide a brace or prosthesis for a dog, you can see immediate results, and you can see that you’re doing some good,” says Alaimo. “The people that are coming to you are the people who really want the services and are willing to pay for them without question...we’re dealing with people who really want to help their pets.”

Pushing for Education

Although each professional has his or her own method of fabricating devices and providing care, most can agree on one thing: the value of animal O&P education. It’s increasingly important for everyone from veterinarians to pet owners to learn what this practice has to offer and that it is a viable option for pets.

Both Alaimo and Collins say educating veterinarians and clients is their biggest challenge. While people might find it easy to accept that O&P offers health-care solutions, they might find the financial responsibilities, especially in difficult economic times, harder to welcome.

Orthotic braces are typically fabricated out of lightweight polypropylene, co-polymer, and polyethylene, which are durable, long-lasting, and easy to clean. Carbon graphite or pre-impregnated composites can be used in braces for extremely active dogs or those with weight issues. A typical brace can be provided to a dog with a knee injury for approximately $700; that’s a viable option when you consider that surgery could cost upwards of $3,000.

V-OP “gives owners and their pets another alternative that they never had before,” says Alaimo. Plus, he adds, with surgery there are no guarantees. After the operation, a very active dog could easily blow out that knee again.

Typically, most animal amputations are done at the hip or the knee, and after the fact it becomes very difficult to fit an animal for a device when there is no knee or elbow joint. By advocating for amputations that are lower down on the leg—below the knee or below the elbow— Alaimo notes that he can provide a device that fits properly and “provides equal balance. . . And more four-legged support,” which will help avoid further injury and stress to the other limbs and the spine.

The most common injury in dogs is to the CCL, which functions to stabilize the tibia. According to the American Kennel Club Canine Health Foundation website, “lameness in the rear leg is the most common sign of a CCL rupture. Other symptoms can include pain and swelling of the joint.” Orthotics for CCL injuries account for about 50 percent of devices sold. Carpal and tarsal injuries also are common, each accounting for about 25 percent of business.

While constant educational advocacy is challenging, the work makes it all worthwhile. Alaimo and Collins state that giving animals back their quality of life is the most rewarding part of their jobs.

Another benefit: O&P pet health care can bring immediate results. Once a dog that has been held back because of a knee injury gets fitted with a brace, he or she can immediately be observed prancing around the office. It’s a great feeling, says Alaimo, “getting that response back from the owners of how much more the dog can do and how much happier it is, that his tail is wagging again.”

After all, he says, a wagging tail is a dog’s way of saying “thank you.”

Lia K. Dangelico is a contributing writer to O&P Almanac. Reach her at ldangelico@strattonpublishing.com.

Q&A WITH KEVIN CARROLL, HANGER’S VICE PRESIDENT OF PROSTHETICS

O&P Almanac asked Kevin Carroll, MS, CP, FAAOP, vice president of prosthetics for Hanger Clinic, a few questions about the growing animal O&P industry. With 30 years of experience as a practicing clinician, Carroll helped to develop WintersGel, the innovative liner material used to successfully fit Winter the dolphin—recently featured in the film Dolphin Tale—with a prosthetic tail.

O&P ALMANAC: What are some of the biggest differences between creating orthotic/prosthetic devices for humans and creating them for animals?

CARROLL: Communication is certainly a big difference with animal vs. human patient care. With human patients, we’re able to communicate directly with them, unless of course we’re working with a child and need to communicate with the parent. With animal patients, we have to communicate with their owners, and pay very close attention to the animal’s body language.

Additionally, animals’ anatomies are very different than the anatomy of a human. Working very closely with veterinarians, we must have an understanding of the particular animal we’re working with—whether it be a bird, dog, dolphin, sea turtle, etc. The different anatomies of animals can also require different types of components than we use when providing care to our human patients. Some of which need to be special ordered, and some, such as the WintersGel liner used to fit a prosthetic tail on Winter the dolphin, are created throughout the research and development process.

O&P ALMANAC: How big of a cost difference is there between the two?

CARROLL: The time and involvement to fit an animal with a prosthetic or orthotic device is almost identical to that of providing care to a human, so the cost is very comparable. In some cases, it may even take longer to build a device for an animal since we’re working in a completely different territory and it is not something we’re used to.

O&P ALMANAC: Why do you think the veterinary O&P field is experiencing such growth? What is the draw for professionals?

CARROLL: With a greater awareness of the availability of orthotic and prosthetic devices for animals, owners of animals are more willing than ever to manage cost for their pets. There are also higher expectations for people to care for animals. I think it’s a great way to give back to society. A lot of times, we go into it with the goal of helping the animals, but, at the end of the day, they end up giving more to us than we give to them.
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