290 Canine Sports Medicine and Rehabilitation
Prescription requirement
According to the BOC model licensure act for
human practice, “A licensed orthotist, prosthe
tist, pedorthist or orthotic fitter may provide
care or services only if the care or services are
provided pursuant to an order from a licensed
physician or licensed podiatrist” (www.bocusa.
org/files/BOC_Model_Licensure_Act.pdf;
accessed October 2017). Again, this is based on a
model licensure act and is not required in all
states. Unfortunately, at this time the same can
not be said for non‐human patients or fabrica
tors of devices for nonhuman patients. This
means that clients can order V‐OP devices with
out the guidance of a veterinarian, without a
prescription, and without veterinary follow‐up
care. Devices are frequently ordered from online
entities. Working with animal patients is not the
same as working with human patients because
of the vastly different biomechanics and patho
mechanics of the quadruped. Just as cats are not
small dogs, Chihuahuas are not small
Greyhounds, and quadrupeds are absolutely not
small people on all fours. Veterinary species are
tremendously diverse and challenging for many
reasons, not the least of which is that these
patients are not verbally self‐reporting and
advocating. Therefore, a fabricator should be
appropriately H‐OP certified and have a great
deal of veterinary patient experience before pro
viding a device for any companion animal.
Because of this, it is incumbent on the attending
veterinarian to educate and advise their clients
and to perform due diligence in selecting a fabri
cator. Although currently not regulated, prudent
practice dictates that V‐OP devices are pre
scribed by a veterinarian with a valid doctor‐
patient‐client relationship and, further, that
ongoing care be managed by a veterinarian.
Key questions to ask when selecting
a reputable fabricator
The following are listed beginning with strong
est recommendation:
(1) What is the certification type/scope of
practice of the fabricator?
(2) What is the fabricator’s veterinary caseload?
Do they work with animals exclusively or
work with animals as a side business? With
what species has the fabricator worked?
(3) Does the fabricator require a prescription
from a veterinarian with a valid doctor‐
patient‐client relationship for all cases?
This is a matter of professional ethics; in
the opinion of the authors, if a prescription
is required for a human patient, veterinary
patients should receive the same standard
of care.
(4) What level of support and customer ser
vice is available from the fabricator? This
is particularly important for the novice V‐
OP veterinarian.
(5) Does the fabricator have a close working
relationship with a collaborating veteri
narian other than the prescribing veteri
narian who can provide consultation and
guidance with regard to animal health,
locomotion, behavior, wound manage
ment, and rehabilitation?
(6) Does the collaborating veterinarian have
advanced training in sports medicine,
rehabilitation, and V‐OP? There are sev
eral interest groups and specialty boards
providing certification and continuing
education for veterinarians. These include,
but are not limited to, the Veterinary
Orthopedic Society (VOS), American
College of Veterinary Sports Medicine and
Rehabilitation (ACVSMR), the American
Association of Rehabilitation Veterinarians
(AARV), the Canine Rehabilitation
Institute (CRI), and NorthEast Seminars.
Association with such organizations is
ideal for any veterinarian providing fre
quent consultation to a V‐OP fabricator.Summary
V‐OP is a novel and potentially significant
addition to the practice of canine sports medi
cine and rehabilitation. It is not a panacea and is
not for every client or patient. Thorough evalu
ation is required as a prelude to specific diagno
sis and V‐OP prescription.
Much work is needed to provide a scientific
basis for the anecdotal advantages of V‐OP
devices. Current basic research supports mov
ing forward, but clinical studies are lacking.
Until such a time as a body of highest quality