Nabaneeta Smaraki1 , Harsh R Jogi2
1Ph.D. Scholar, Division of Veterinary Microbiology
2Ph.D. Scholar, Division of Veterinary Microbiology
ICAR-Indian Veterinary Research Institute, Izatnagar-243122, U.P.
Anastounding yet, likely reconsiderable step in the progression of increasing expertise in medical miracles for animals has been the development of animal-tailored prosthetics.With the amalgamation of information from human orthopedics and biosciences, veterinarians & engineers have been able to develop effective and technologically advanced animal prosthetics. As per Mr. Derrick Campana- a world renowned orthotics creator, who has helped over 20,000 animals in the last 18 years ranging from dogs & cats to camels, horses, sheep, birds, and elephants. According to him, we can add 2 more years to a dog’s life by providing it with a prosthetic when it needs.
When a limb cannot be salvaged for medical or financial reasons, it is a common notion that dogs and cats do “great” on 3 legs. Three legs may mean a less functional limb or outright total amputation. Vets are supposed to espouse this doctrine upon their clients. Although it is true that many patients adapt, learning to ambulate and negotiate their environment. But, this functional adaptation does not necessarily provide the highest quality of life. As a profession, we have come to expect—even accept—that limited mobility, limb breakdown, and chronic pain are unavoidable consequences. The short- and long-term consequences of limb loss or altered limb function are not benign as once thought. Furthermore, the quality of care and the breadth of knowledge afforded by technology and global communication generate innovative therapies readily accessible to the computer-savvy pet owner. Often there is no precedent for these new therapies in animals, and the onus rests with the veterinary community to educate itself to provide best care for patients and clients and to establish evidence-informed best practice. The newest emerging therapeutic modality is veterinary orthotics and prosthetics. Legs, beaks, fins, or any damaged anatomy that vets have successfully replaced with artificial gadgets represent the latest crossover fashion of human medicine to veterinary medicine that has greatly changed the art of healing sick & injured animals.
In humans, an artificial limb can be rehabilitated physically and emotionally. Animals do experience similar effects, but they cannot express directly what they go through. Indeed, the existing response for many animals fitted with prosthetics is to parade around as though nothing is unusual. Thus, being a veterinarian, it is our prime duty to understand the unspoken pain and feelings of animals.
REASONS BEHIND THIS NEW PERSPECTIVE
Over the past decade, there has been a tremendous increase in our understanding of physical fitness for animals coincident with an increased demand for maximizing quality of life for our companion animals. Rehabilitation has moved to the forefront of modern veterinary medicine with new developments in that aspect. As our understanding of the intricacies of quadruped mobility and biomechanics has grown, so have the variety and sophistication of mechanical assistive devices. After the incorporation of veterinary-specific hinges, composite plastics, titanium, carbon fibre, and specialty foam liners in the developed prosthetics and orthotics, the variations have grown tremendously. Biomechanically sound designs improve fit and function. Surgical techniques such as subtotal amputation, intraosseous transcutaneous amputation prosthesis (ITAP), and rotational plasty are providing new opportunities and an expanding patient population. Although it is true that techniques and materials used in H-OP can be translated to veterinary patients, specific modifications for quadruped ambulation and the significantly greater magnitude of force generated by these patients must be considered. A thorough understanding of the biomechanics and health issues of animals is essential to avoid injury to the animal, delayed healing, or delayed use of more appropriate therapies.
The veterinarian is the key player in this process and must lead the way because of their knowledge of veterinary species and veterinary medicine. To do so, veterinarians must begin to educate themselves in this regard to best serve the demands and needs of their clients and patients.The loss of limbs in pets & their wild counterparts can occur as a result of injury or diseases like cancer. In case of any four-legged animal, even after amputation of one leg due to any such unforeseeable circumstances; it is a misconception that such animals can adjust freely to it. Rather, the irregular motion & weight distribution take a toll on the rest of body for defying center of gravity ultimately shortening life spans & reducing the life quality. Lopsided yet resilient, they evoke a kind of fawning sympathy from us humans that is unmatched by the typical quadruped canine. People are usually drawn to specially abled pets mostly the animal lovers because of their willingness to help and pity upon them. We can find commonly circulating images of many such animals on social media like- a dog with prosthetic limbs or wheels, cat with bionic hind legs, tortoise with wheels, artificial beak in birds and so on. 3D printing has propelled the industry forward that are light weight, affordable, and infinitely customizable.
HOW IT HAS HELPED IN REHABILITATION
In recent years, prosthetics and orthotics have garnered significant attention for their role in rehabilitation. Whereas, pets enjoy the security of human guardianship, wild animals find safety in the freedom of nature. Their trust in forests, oceans and other habitats have left them as a subject not only to perils of nature but also as prey to human dangers. They need a greater degree of care & compassion to trust the good deed done till they can return to wild where they must compete for their survival again. It is quite difficult at first to even help such needy animals as they usually remain deeper in the forests. But thanks to various surveillance systems, motion cameras that detect any such anomalies and the rescuers jump into action. The noble efforts of wildlife rescue workers & veterinarians have been truly inspiring and in some cases is wonderfully triumphant.
BASICS OF ORTHOTICS AND PROSTHETICS
Orthoses provide protected motion within a controlled range, prevent, or reduce severity of injury, relieve contracture, allow lax ligaments, and joint capsules to shorten, and provide functional stability for an unstable limb segment. These devices aid in complementary or adjunctive function for any limb discrepancy. Importantly, these devices do not create dependency or atrophy unless intended or is an unavoidable consequence of severe injury. In cases where surgery must be delayed, they can provide interim support, protect the limb, allow more comfortable and mechanically appropriate ambulation, and minimize disuse atrophy. In a postoperative situation, orthoses can provide a safe, effective, and dynamic alternative to traditional casting.
However, the current dogma goes like this: “animals do great on 3 legs.” This position advocates for total limb amputation when catastrophic injury or pathology arises. However, the short- and long-term structural consequences of a missing limb or limb segment are being underestimated or not studied in detailed manner. Currently there are 2 types of prosthetic limbs available: socket based and ITAP. Socket-based prostheses provide a socket within which the residual limb rests; an extension provides contact to the ground via some form of foot or paw. The key for socket-based prostheses is suspension and retention of the device on the residual limb. ITAP provides an implanted endoprosthesis to which an exoprosthesis is attached. Surgery is required and the endoprosthesis is integrated into the bone and skin. Prosthetic limbs for animals are becoming available albeit with simpler models than those for humans. The advantage of socket based prosthetic limbs is their relatively low cost, simplicity of application, and adaptability to many levels of limb loss. The clear advantage of ITAP is direct skeletal integration of the exoprosthesis.
PROUD MOMENT FOR INDIA
It is a great honour for us Indians to have such a legend Dr. Tapesh Mathur, a pioneer who has been making animal prosthetics for the past few years. Even in Indian scenario, he has made it possible to make these prosthetics. After witnessing several cases of amputation, he researched about this in order to provide these animals a normal life. He experimented with molds on a couple of amputee cows, only to see them fail. His first successful attempt was on a calf named Krishna. After undergoing 15 days of physiotherapy, it got slowly accustomed to the new limb. His next exemplary achievement was successful fitting of a new limb in horse. And eventually, he has made many such wonders in the field of prosthetics that has paved a path for new veterinarians to explore and research more in this topic.
Animal prosthetics are a relatively new phenomenon, and this technology is improving at a rapid pace. These devices offer treatment options where none existed before. For chronic or catastrophic injuries, they play an important role in pain management, and can significantly improve, comfort, quality of life. There is improvement in functional independence as well as limit premature decisions to euthanize. In severe case, these devices serve as safe alternatives to traditional casting and splinting while providing the opportunity to initiate rehabilitation earlier. Secondary or compensatory pain can be minimized by correcting or improving gait mechanics and reestablishing quadruped locomotion. Behind the scientific & medical wizardry of these artificial creations, the magical after life of beloved pets & wounded creatures in wild will always be extraordinary. Their stories reveal the power of compassion & technology to renew the spirit of ailing animals.