Chapter 11 Veterinary Orthotics and Prosthetics 285related to client resources. Fortunately, with
the establishment of expectations prior to mov
ing forward with a prosthesis, many clients
find the time and financial commitment man
ageable when considering the chronic health
issues and costs associated with full limb
amputation.
V‐OP evaluation, objectives,
and goal setting
It is important to establish a logical and thorough
approach to V‐OP patient evaluation. It is essen
tial to dedicate extended time for the initial visit.
This preliminary evaluation combines aspects of
general physical, neurological, and orthopedic
examinations as well as musculoskeletal and bio
mechanical evaluation (Box 11.3). The compre
hensive assessment of each patient will likely
result in a multipartite diagnosis; this is because
the interrelated function of the whole body is
considered rather than simply focusing on the
chief complaint. The ultimate objective will be to
provide an accurate diagnosis, appropriate pre
scription, and treatment plan to meet client and
clinician expectations and goals.
Components of the V‐OP evaluationObservation
Observation is essential and includes assessment
of behavior in stance and ambulation. The ideal
V‐OP examination room is large with nonslip
flooring and without an examination table. The
patient should be allowed to explore the room
freely while the history is taken. This provides
time for acclimation and movement observation.
The patient can also be examined while walking
in an open area outside prior to entering the
exam room. Props such as stairs, low hills or
inclines are handy for challenged gaiting and
mimicking the activities of daily living.History and client goals
In addition to a thorough medical history includ
ing onset of injury, recent diagnostics performed,
medications, supplements, and response to
other therapies, the V‐OP history should include
information about past and present activity
level, sport, or job, daily structured and non
structured exercise, home and play environment
(flooring, bedding, yard, stairs), and lifestyle
(children, other pets, primary caregiver). These
specific questions are important in determining
the appropriateness of a prescribed V‐OP device,
its design, treatment plan, and implementation.
For example, a home environment with hard
wood floors versus carpeted floors may necessi
tate a different tread system; or a home in which
the patient may freely roam at night may alter
the wearing schedule of a device.
Next, client goals must be established. For
example, is the intent to return a patient to
world‐class competition or is the intent an
alternative to surgery because surgery,
although recommended, is not possible? Of
particular value is understanding why a client
is seeking a V‐OP therapeutic option. Common
rationales for orthosis include: (1) no surgical
alternative; (2) advanced age of the patient;
(3) comorbidities; (4) poor anesthetic risk; or
(5) financial constraints. It is important to
establish client aims to select the appropriate
therapy and to set realistic expectations. For
example, in the case of a stifle orthosis for cranial
cruciate insufficiency with meniscal damage, if
financial constraints are the primary rationaleBox 11.3 V‐OP evaluation summary● Observation outside
● Observation of free movement in exam room
● History: includes activity level (before and
since the injury, structured and unstructured),
home environment (flooring, stairs, yard, dog
door, etc.), lifestyle (other animals, children,
primary caregiver in the home)
● Client goal(s)
● Media acquisition (conformation, stance,
gaiting) to include all four sides of the dog
● Examination:
❍ General health examination
❍ Neurological examination
❍ Orthopedic examination
❍ Myofascial examination (including specific
flexibility)
❍ Passive range of motion goniometry
● Diagnostic testing as needed (e.g., screening
blood analysis and urinalysis, radiology, ultra
sound, CT, MRI, SOD1 DNA testing)
● Comprehensive analysis resulting in diagnosis
and prioritized rehabilitation problem list
● Prescription for V‐OP device if appropriate