ABSTRACT: Animal osteopathy has wide application and is not solely for the backs of agility dogs and competition horses. An osteopath considers the whole animal and examines areas distant from the site of injury, in addition to the injury itself. An osteopath applies this approach to any species of any size. Animal osteopath, Claire Short, treated Sylvester, a rabbit unable to hop straight. Examination revealed a shoulder injury, so osteopathic techniques were used to improve the movement of the gleno-humeral joint and surrounding structures. He responded well to treatment; shoulder movement improved, and all compensatory patterns from the injury disappeared.

As an animal osteopath, my patient list is normally made up of horses and dogs, many of whom are athletes (competition horses and working dogs). Like any human athlete, they can require regular maintenance work, or rehabilitation following an injury. Given that rabbits are not renowned for their dressage, agility or show jumping skills, they tend not to come in for treatment; but Sylvester may well have changed this trend.

Sylvester, it has to be said, is a stunning rabbit. He is a silver Rex and has a coat the texture of chinchilla fur. What immediately caught my attention, however, was the fact that his hop was lop-sided. He was not limping and showed no signs of being in pain, but his movement was not balanced, and he was, dare I say, not a ‘happy bunny’.

Formal qualification

The preparation and training required to properly practise osteopathy on animals is quite complicated. First of all, it takes about six years to qualify. The initial five years now lead to a degree in human osteopathy. You cannot call yourself an osteopath unless this training has been completed. A postgraduate course then qualifies you to work with animals.

Even then, it is a legal requirement to obtain a vet’s permission before you can treat an animal. To treat without consent invalidates any practitioners insurance. These days most vets are very familiar with what osteopaths can achieve and are happy to give permission.

After qualifying as an osteopath, my own patient list has included alpacas, a gecko, sheep, a baby squirrel, turkeys and a buffalo (Figure 1). These more exotic creatures tend to be expensive livestock or rare breeds that have sustained an injury and whose owners want treatment so that the bloodline can be maintained. Admittedly, the gecko and the baby squirrel are exceptions. Still, I confess that until I started doing voluntary work at Northamptonshire Animals in Need of Nurturing (NANNA), I had never been asked to treat a rabbit!

Figure 1: Claire using her full body weight to improve the movement of a buffalo's thoracic spine

Case in point

Getting back to Sylvester, permission was quickly granted and 1 was able to examine him to investigate his unhappy hop. When an osteopath examines an animal we look at the whole body, not just the injured area. We do this for several reasons.

Firstly, it gives us a full picture of what might have made the animal (or human!) vulnerable to this particular injury. It also allows us to work out where the compensation injuries are developing, and it provides a picture of how the musculo-skeletal system of the animal works as a unit. This is probably what sets osteopathy apart from other treatments.

Our philosophy is based on structure and function being reciprocally related, which means there is no point fixing a shoulder problem if the underlying cause is low back pain, because the shoulder problem will simply recur at a later date.

Joined-up approach

So how on Earth does low back pain cause a stiff shoulder? There are many ways this can happen. One very simple example is to consider the attachments of the latissimus dorsi. This powerful back muscle attaches on to the iliac crest of the pelvis and the top of the humerus. Damage to, or over use of, the muscle can, therefore, have an effect on the shoulder or the pelvis.

Similarly, if an animal is lame behind, it will put more weight on the forelimbs, so the muscles in front have to work harder and become painful – they may even present in clinic as the site of injury. So our approach to the body is based on mechanics and the connections between different parts of the body, which is why examination of the entire body, excellent palpatory skills and a thorough knowledge of anatomy are essential.

In Sylvester’s case, all the problems were in the upper body – in the shoulder joint itself, in the muscular links between the scapula and the ribs, and in the vertebrae of the neck and upper back. Initially his treatment was weekly, and was accompanied by the famous ‘rabbit-wriggle’.

For anyone who does not treat small animals, the ‘rabbit-wriggle’ is a highly specialised move developed by rabbits. It gives them the ability to suddenly slither out of human arms and avoid treatment of any variety. In fact, it was only during his second session that Sylvester finally settled and started to look like he was enjoying his treatment (Figure 2).

Figure 2: Working through Sylvester's hypertonic peri-scapular muscles with finger tips

Our philosophy is based on structure and function being reciprocally related, which means there is no point fixing a shoulder problem if the underlying cause is low back pain, because the shoulder problem will simply recur at a later date.

At each appointment, I worked on the peri-scapular muscles and the muscles of the neck and back. I would then mobilise the shoulder joint and the vertebrae in his upper back and neck. Some of the techniques for releasing the muscles around the shoulder were clearly uncomfortable for Sylvester, but none of them was very painful.

After each session, it was obvious that Sylvester could move more easily, and that his hop was gradually becoming more normal (Figure 3). As his movement improved I was able to allow bigger gaps between appointments until he was only being treated every three or four weeks.

Figure 3: Using her fingers to support the limb. Claire uses the heal and palm of her hand to encourage movement through the gleno-humeral joint, the upper ribs and the thoracic spine

Nobody knows the origins of Sylvester’s stiff shoulder. The lack of heat and swelling suggest it was not a recent injury and that a fall or play-fighting in the cage some years ago could have caused muscle shortening or scar tissue to form – both of which could restrict movement through the shoulder joint.

This is just the same for humans – sometimes scar tissue, shortened muscles or joint damage from an old injury cause stiffness later on. Rehabilitation for human patients often requires a mix of treatment and exercises. Unfortunately rabbits are particularly useless at doing their exercises, so I treated Sylvester more often than I might have treated a human with a similar
injury. Had Sylvester had an owner, I would have asked for exercises to be done at home, so he would not have needed so many appointments.

Part of the problem for Sylvester was that he had to live in a cage because he was in a rescue home. The cages at NANNA are bigger than average, but they still restrict the amount of space he has for keeping active. Joint stiffness is not uncommon in caged animals that do not have the opportunity to move their limbs freely; though the complexity of Sylvesters problems makes me think his injury preceded his time at NANNA.

Tail piece

Osteopathy can be helpful for any species of animal on restricted activity, as treatment keeps the joints mobile and the muscles healthy, both of which make the animal more comfortable and decrease stress levels.

So, Sylvester the rabbit did go to the osteopath, and he improved with each treatment. The fairy tale ending, however, is that he was re-homed at Easter and now has a very large run in which to play. I am reluctant to use the phrase ‘happily ever after’, but I can report that to date there has been no recurrence of his shoulder problem. 

Author

Claire Short DO

Claire qualified and registered as an osteopath in 2000, and, driven by a passion for horse riding and a fascination with exotic animals, went on to obtain her Diploma in Osteopathy for Animals in 2005. She is based in Higham Ferrers, Northamptonshire, where she is co-director of The Ashgrove Clinic; but her work with animals takes her across most of the Midlands and south east England, and even overseas when her international level equine patients travel abroad.

For more information about animal osteopathy, e-mail: claire.short@ashgrovehealth.co.uk

To cite this article use either

D0I: 10.1111/|.2045-0648.2011.00063.x or Veterinary Nursing Journal Vol 26 pp 246-247

Veterinary Nursing Journal • VOL 26 • July 2011 •