266 Canine Sports Medicine and Rehabilitation
Historical perspective and
the advent of veterinary orthotics
and prosthetics (V‐OP)
The use of orthotics and prosthetics to assist
humans in ambulation and functional inde
pendence was first recorded in 2700 BC
(Seymour, 2002). In the past century, veterinary
medicine has advanced in technology and
sophistication coincident with the increasing
value and importance of companion animals.
State‐of‐the‐art veterinary health care now
includes a new industry called veterinary
orthotics and prosthetics (V‐OP). This industry
has been emerging for the past decade. The
acronym distinguishes it from the human
specialty, referred to as H‐OP.
The techniques and materials used in H‐OP
have been used in the establishment of V‐OP.
These include mechanical hinges, composite
high‐temperature plastics, carbon fiber, custom
prosthetic feet/hands and dynamic motion‐
assist mechanics. Additional design, manufac
turing methods, and componentry are required
to account for quadruped ambulation and the
significantly greater magnitude of force gener
ated by veterinary patients relative to human
patients. With a clear understanding of the
intricacies of quadrupedal and tripedal biome
chanics, the proper application of V‐OP aids in
ambulation, recovery from injury, and func
tional independence.
Specific advances in the manufacturing and
design process have improved V‐OP solutions
over the past decade. The 20th century saw a
dramatic increase in the ability to manufacture
human orthoses and prostheses more efficiently
(Klasson, 1985). Specifically, the advent of
computer‐aided design (CAD) systems provided
the orthotic and prosthetic industry with tools to
bring subjective design creativity to an objective
application of biomechanics (Fairley, 2013).
State of V‐OP practice: empiricism
versus science
The use of V‐OP devices is a rapidly emerging,
therapeutic strategy. The goal of this chapter is
to introduce basic concepts for the novice
practitioner. First a bit about terminology:
colloquial language refers to these devices as
orthotics or prosthetics. Perhaps we put too fine a
point on it, but the appropriate nouns are
orthosis and prosthesis with the plural of each
orthoses and prostheses. The former are adjec
tives as in orthotic device and prosthetic limb.
Further, an orthosis is defined as any medical
device attached to the body to support, align,
position, immobilize, prevent or correct
deformity, assist weak muscles, or improve
function (Deshales, 2002). A prosthesis, by
contrast, is an artificial device used to replace or
augment a missing or impaired part of the
body. This may include heart valves, ligaments
or dental implants, among others. For this
reason, we use the term prosthetic limb for
clarity. By definition, a prosthesis may concur
rently act as an orthosis, while the converse
cannot be said. A term for the former is prosthosis.
Traditionally, veterinarians have been quite
adept at fashioning orthopedic assistive devices
from any number of on‐hand materials such
as PVC pipes, aluminum rods, thermoplastics,
and fiberglass/plaster casting. Just as veterinary
medicine has evolved to include advanced den
tistry, joint replacements, chemotherapy, and ste
reotactic radiation, it is in turn evolving toward
the application of advanced biomechanics and
technology for the treatment of limb loss and
loss of limb function. The potential advantages
afforded by biomechanically appropriate, cus
tom orthoses and prostheses over homemade,
improvised devices include: (1) improved man
agement of primary pain generators associated
with functional impairments; (2)improvement in
the accuracy/ appropriateness of biomechanical
therapeutics, which may allow for greater activ
ity and a significant decrease in secondary and
iatrogenic pain; (3) return to active lifestyle,
resulting in decreased obesity and associated
comorbidities; (4) improvement in quality of life
and functional independence; and (5) the avail
ability of treatment options where none existed
before (Marcellin‐Little et al., 2015). All of these
can prevent a premature decision to euthanize.
An internet search in January 2017 found as
many as 18 companies offering custom and
off‐the‐shelf devices for veterinary patients.
A search of internet chat groups and blogs
found the most commonly discussed devices
were for canine cranial cruciate injury.
Coincident to this increased interest in devices,
technology is changing with the use of CAD,