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Best Rehab Therapy Treatments for Tripawds with Dr. Mandi on Tripawd Talk Radio #122

How do you know how far is too far when walking your Tripawd? And when is it too early to start rehab exercises after amputation? Find out with Dr. Mandi Blackwelder on episode #122 of the Tripawd Talk Radio podcast.

Teaching a client how to do exercises is so, so valuable because even if it’s not new to them, that dog has compensatory patterns or is learning compensatory patterns. we want to help them avoid some of the things that potentially could lead to further injuries.

Dr. Mandi Blackwelder,

Watch for a second Tripawd Talk with Dr. Mandi, where we discuss prosthetics for three-legged dogs and cats!

All About Rehab Treatments for Tripawds with Dr. Mandi Blackwelder

This episode is all about the benefits of proper rehabilitation treatment and exercise for three-legged dogs and cats. Dr Mandi Blackwelder of Healing Arts Animal Care in Beaverton, Oregon shares her whole body approach and multi-faceted treatment for amputee dogs including nutrition, supplements, chiropractic care, massage, and of course rehab exercises.

A full transcript follows the YouTube podcast video below.

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Dr. Mandi has been practicing veterinary medicine since 1998 and she was first certified as a canine rehab therapist in 2013. She has been keeping current with all of the latest rehab therapies and she has seen her share of three-legged patients. Her approach to animal care is one that considers the whole body and a multifaceted treatment approach that may include nutrition, supplementation, chiropractic, massage and of course rehab exercises.

Learn more about Dr. Mandi or make an appointment at

What You Will Learn

  • Introduction of Dr. Mandi
  • The critical role of rehabilitation in a Tripawd’s life
  • Specific needs and treatments for three-legged dogs and cats
  • Importance of certified rehabilitation professionals

Common conditions and therapeutic modalities such as:

  • Exercises to strengthen the core and compensate for the loss of a limb
  • Overview of chiropractic care
  • Walking and exercise recommendations
  • Underwater treadmill and swimming

And finally, why it’s SO important to seek professional rehab consultation

Get reimbursed for your Tripawd’s first visit with a certified rehab therapist at

Watch Rehab for Tripawds Interview on YouTube

See all Tripawds Rehab Articles

See how other Tripawds benefit from rehab therapy

Tripawd Talk Radio

Tripawd Talk Radio #122 Full Transcript

Jim: Hello again. Welcome back to Tripawd Talk Radio. We’re Rene and Jim and this is episode number 121. You know, we are all about rehab, rehab, rehab when it comes to keeping tripawds fit and strong and it has been quite a while since we talked about the benefits of proper rehabilitation here. So we are excited to have Dr. Mandi Blackwelder from Healing Arts Animal Care with us today to talk all about rehab.

Dr. Mandi: Absolutely. Nice to be here.

Rene: Hey, I heard you liked to be called Dr. Mandi. So that’s what we’re going to call you.

Dr. Mandi: Hey, that’s what everybody calls me.

Rene: Awesome. We’re so happy to have you here because we haven’t had a rehab therapist on for a while and as you know, we are rehab-crazy at Tripawds. Can you start by just giving us a little bit of background on who you are and what you do?

Dr. Mandi: I own a rehabilitation-specific practice in Beaverton, Oregon, which is just outside of Portland. We do multiple rehab modalities though it’s an exciting field to be in because there’s always new stuff. You’re like, “Oh!” Like I just learned yesterday that there’s such a thing as an electro stim whirlpool. I was like, “What is that?”

Rene: Whoa!

Dr. Mandi: There’s always new things in this field, which is really exciting and it’s very much driven by the human physical therapy side, so that’s really exciting. My background actually, I went to vet school to be a large animal veterinarian.

I was planning on spending the rest of my life in the Midwest doing cows and pigs and a little bit of a circuitous story but had you told me that I was going to be doing small animal specialty practice on the East Coast in a city, I would have been like, “You are smoking something!”

But that’s where I landed and I love what I do. We’re about to move from an 1100-square-foot facility to a 5000-square-foot facility. A little nerve-wracking but very excited to be able to expand to that point and be able to offer more and more to the community.

Rene: Was there a particular situation, a client that got you focused on rehab in particular and how did you end up on the West Coast?

Dr. Mandi: When I was in veterinary school, rehab wasn’t really a thing. I graduated 1998 but at that point, Washington State University had a small program and there was somebody at my vet school who was in connection with them who was sort of on the slide doing this.

Like the students didn’t really know about it and I heard about it. I kept sort of like popping my head in there and then as I – I did acupuncture training while I was in vet school and the sort of “whole pet approach” was something that just was ingrained in me from the beginning. Maybe it’s because I’m from Boulder, Colorado which is very airy-fairy. I don’t know.

In doing cattle, like that whole animal approach is really important because nutrition matters and are their feet comfortable and all of those things that sometimes get lost in small animal medicine. It’s actually very important in farm medicine. You’re going to have better production, better meat, better milk, whatever we’re talking about if the whole animal is doing well.

My large animal practice that I was a part of literally worked me to death and I went looking for another job, had lots and lots of offers and at that time which unfortunately I think is still kind of the case.

The large animal industry was not getting what has happened in small animals which is that most of us are women and that we have families and women tend to be the head of their family households and you need to be able to figure out how not to work 24 hours a day.

I didn’t have a family at that point but I was like “I don’t want this to be my life” and I actually came to Oregon to interview at a dairy practice in Estacada. But I interviewed in this little town Grants Pass as a part of that and I really liked the practice where I interviewed. It sounds funny now but I was like he was offering an exorbitant amount of money. It was $50,000 a year and so I ended up there and so that’s how I ended up on the West Coast. That job was a great – we had a lot of freedom in what I was able to do in medicine. I could do kind of my holistic stuff but it was a really tough place to work.

I finally reached a place where I was like I really want to do rehab and so called up mom and dad and said, “Can I borrow the money to do this?” and they said, “Sure.” So I got certified in rehab.

Rene: What year was this?

Dr. Mandi: That was in 2012. I did the course at CCRP course at University of Tennessee and the next part is kind of hilarious. I have a friend who’s a veterinary dentist and she was doing her residency in Portland while running her practice in Southern Oregon. She said, “Well, Mandi, Carol Helfer’s practice is just sitting empty.” I said, “Who is Carol Helfer?” and she said, “She’s rehab. She has been doing rehab forever.”

It’s true. She was doing rehab for 17 years in 2011. But she passed away and her practice was just sitting empty which is the craziest needle in a haystack ever. That was on a Saturday I had that conversation. My husband and I drove up here on Wednesday, the practice from her estate and then moved on up to Portland, which has been great for my family.

I’m very surprised how well I became a suburbia girl although it will get me remotely close to the river and downtown. I get like all county.

Rene: I hear you, I hear you. We’ve spent time in Portland. Yeah, I would much rather be on the outskirts for sure.

Dr. Mandi: It’s a beautiful city and it’s great. Plus I have a handicapped son so lots and lots of opportunities for him, which is great. But I would – you know, send me out to country any day.

Rene: Well, the people and animals of the area are very lucky to have you there. And now when you were training to be a rehab therapist, is it what you thought it would be once you started practicing? What were some of the big surprises when you got into it?

Dr. Mandi: I think for me, the biggest surprise is kind of the niches that can happen. So in order to be a rehab therapist, you have to either be a veterinarian, a certified veterinary technician, a doctor of physical therapy, a human doctor of physical therapy or a human physical therapy assistant.

What was a big eye-opener for me was that as a veterinarian, I’ve now realized I really do more like a naturopathic medicine. I look at the whole dog and everything that’s going on with the dog and is your nutrition right, to make sure that your muscles are working, like all those things.

On the PT side of things, it’s much more like human medicine, that this is your area of focus and you’re focused on making sure these muscles and joints work better, but not necessarily the whole dog.

Now there’s nothing wrong with that and the human physical therapists have taught me so much about their side of things, manual manipulation, a lot of the things that they know having gone to PT school that I don’t know. But scope of practice is different and I think that clients don’t necessarily understand that.

If you’re a vet-ish person, they’re thinking, “Hey, can you look at my dog’s teeth?” Right? I did too and so I was like, “How do you manage that? How do you do that?”

That was really surprising to me and it allows people to have a choice in kind of, “Do you want the whole ball of wax or you feel like you’re getting that from the chiropractor, like whoever else you’re seeing?” and do the human physical therapy side.

Then as a vet tech and as a human physical therapist, depending on your state, but in most states, you have to work on a referral basis from a primary veterinarian. So in a way, you’re working under that veterinarian’s license, which are also working under that veterinarian’s diagnosis.

That gets a little bit sticky for the practitioner because if the diagnosis is either big or inaccurate, you have to tap dance a little bit and be like, “Hey, I need you to go back to your vet and let’s investigate this a little further.”

You can’t say, “Hey, your vet has made a mistake. You have a ruptured cruciate,” right? So I am excited to see that as this particular area of veterinary medicine grows, that we are collaborating with each other to make that. You know, make veterinarians learn more about PT as PT is and that the PTs can then have the support of the veterinarians to take care of the rest. But we all just need to understand the scope of practice.

Rene: Yeah, and I really love the way it has evolved over the years because when we first started Tripawds, there were still a lot of people out there who could go and call themselves a therapist and not be under the guidance of a vet and then a few years into Tripawds, we learned really the gold standard is to have a therapist who works closely with the vet. Even better, have them be the vet.

Dr. Mandi: Yeah, or at the very minimum certified. I mean because there’s a practice here in town that nobody is certified and they’re doing …

Rene: Still out there, huh?

Dr. Mandi: Uh-huh, they’re still out there. There’s a lot of them.

Rene: Well, that’s one reason why the Tripawds Foundation Rehab Reimbursement Program will only reimburse if somebody has gone to a practice with certified practitioners. It’s just the way it has got to be. I can’t imagine going to a human physical therapist who wasn’t credentialed. That’s kind of scary.

Dr. Mandi: Yeah, and I think – I mean, you know, I think sometimes there’s a disconnect in people’s heads of – you know, it’s sort of like when people get a breeder. Well, they’ve been doing this for 25 years. But have they been doing it well for 25 years? Ask their vet, right? Yeah.

Rene: Exactly, exactly and it really always strikes me that people don’t – they don’t see how closely human PT and canine PT are together. You know, you would not go see a non-credentialed person for yourself. Why would you expect that for your dog or cat?

Dr. Madi: Yeah.

Rene: It’s always great to know that this field is growing. There are more practitioners like you. Our focus of course as you know is on three-legged animals, dogs mostly. But we do get some cats and I would love to know about your experience working with Tripawds.

Maybe let’s talk about those people who came to you after their Tripawd was doing really well after surgery because we get a lot of people whose vets still say, “Oh, just let them be a dog. They will be fine!” The dog does do really well but then maybe six months later comes back and the dog won’t get up that day and has problems.

We see that quite often and it’s no fault of the human because they didn’t know what they didn’t know. Jim and I didn’t know what we didn’t know when we had our first tripawd.

Dr. Mandi: So first of all, I would say cats are the exception. Cats are like liquid and they tend to be – my first boss out of school would say, “Ah! Cats! Put them behind the woodshed. They will get better,” and I mean, well, I disagree with that as a veterinarian.

Three-legged cats very frequently, they just adjust. They’re amazing and I think it’s just because cats are such supple creatures.

Dogs are not nearly as supple and where I would love my colleagues to be paying attention when they’re doing surgery is talking to the person about “Hey, we have just taken a quarter of this dog away, right? And now the rest of the body is having to adjust to that missing piece.”

These guys are going to need some body work throughout their lives, right? Even a young dog who still is kind of liquid, right, we want to be sure that that dog is on a glucosamine and chondroitin supplement because we are asking more of the remaining bones than we were and we want to slow down that progression of arthritis.

We want to – in my mind, ideally, they connect up with a veterinarian who is a chiropractor doing chiropractic because that’s what I find is that a lot of these guys. They’re – just like us, if you’re wonky for a while, you need to kind of get realigned as well as with a massage therapist.

Grom a bare minimum, keeping the dog put together, that’s what I like to see is a good chiropractor. To me good chiropractic is not slamming and jamming. Dogs do not need cracking and a massage.

From a rehab standpoint, the biggest things that I see are hind-limbed dogs that end up with a psoas injury on the other side and that’s because the psoas, it’s a groin muscle that goes from the low back to the inner thigh. It’s one of the things that keeps that leg in. So it’s working a lot harder because it has got to work on that new balance and one little skid out can cause a big problem for them with that.

You know, having people aware of it in the beginning that that’s a potential possibility I think is important and they’re hard to heal, harder to heal in a three-legged dog because they can’t limp. They’re on that leg and so clients need to have appropriate expectations of healing. They’re going to go online and read about, oh, it’s a six to eight-week process.

You know, for a Tripawd, it’s a 12 to 16-week process, assuming they don’t do anything silly in the interim, right? And then four-limb guys, I tend to see either neck discomfort because they’re pulling their head to try to rebalance, right? Or over time, we can get some shoulder strain on the other side like almost like the psoas.

It’s the same concept in the front is that we’re working on balancing in a different way and so that’s where we focus our rehabilitation is on let’s strengthen those muscles that kind of keep everything in the center, particularly the core and go from there.

Much of it depends on how active the dog was in the first place.

You know, a fat lab that had a tumor is a totally different rehabilitation situation than a young dog that had a traumatic injury and lost a leg. You know, your fat dog is going to require a lot more because they don’t have a lot of musculature to begin with.

Jim: Could we talk about the chiropractic modalities for just a minute? Because I think that brings in the discussion we were having about certification.

When we first learned about chiropractic for dogs, there was a certain device a veterinarian could buy and get a little certificate from the manufacturer of that device and then call themselves a chiropractor. Has that changed?

Dr. Mandi: You know, veterinary orthopedic manipulation. So if you go to a human chiropractor, the little thing – it’s called an activator. Kablam! There’s a place for it for sure. But what VOM is based upon is that everything must be out. So we’re just going to bang all of them and see what works.

That’s not OK and particularly because the activator is the same activator for a cat and a chihuahua than it is for a German Sheperd, right? I know. Your eyes got big. Yes. And so an activator has a place in chiropractic medicine but it’s – in my opinion, it should not be the only thing and you’re right. A weekend certificate is not an education in chiropractic.

There’s an association of veterinary chiropractors and there are a couple of different certifications just like there’s a couple of different certifications in rehabilitation and human chiropractors can do veterinary chiropractic depending on the state.

Like in Oregon, it gets very tricky because in Oregon, human chiropractors can be your primary physician but the requirements for school for them is significantly more than it is for other places. But I don’t feel that a human chiropractor that became a veterinary chiropractor could be a primary person. It’s not legal to do that but, you know, let’s be sure we’re all thinking in terms of a particular role.

I personally prefer veterinary chiropractors that are veterinarians. I feel like human medicine requires a bit more heavy-handedness because people are prepared. They’re like, “Oh, you’re going to crack me.” Right? Where dogs are just, OK, whatever.

A gentle touch is so needed as well as a very clear verse on how animals might move or splint themselves. However, a situation many, many people are in, as I was down in Grants Pass, where there isn’t a veterinary chiropractor and there is a human chiropractor that does veterinary stuff, in which case I encourage veterinarians to get to know someone that they can develop a relationship with to share cases.

I think a lot of times veterinarians refer blindly and I don’t think that’s appropriate. So chiropractic is something that can definitely be done wrong and so, you know, to me, the practitioner ideally is sharing how they choose their level of pressure with the pet owner.

Jim: Speaking of pet owners, what conditions or symptoms might the layperson need to notice when they want to ask about chiropractic? Like when should someone consider asking their vet …?

Dr. Mandi: About chiropractic? So any dog that is having stiffness or soreness, chiropractic is definitely an option. Any dog that has had a chronic lameness, that’s appropriate not necessarily for the lameness but for what the rest of the body is doing.

It’s just like for us. If you sprain your right ankle, now your left hip hurts a little bit. Now your right shoulder is out in the left side of your neck. It goes up the body. So that’s where chiropractic can be really nice. There is concern anytime we are treating neurologic disease, a dog with a disc. We have to be sure that no one is treating at the disc, not cowboying it.

But that doesn’t mean that dog can’t have chiropractic. We can work on the rest of the dog. I’m not a chiropractor but the chiropractor can work on the rest of the dog but we do not want to be treating at that disc if it is actively inflamed.

Rene: Would a chiropractor know? Let’s say somebody’s dog has stiffness and their first inclination is to turn towards a veterinary – not a veterinarian chiropractor but an animal chiropractor. How is the chiropractor going to know that’s a really serious issue versus just stiffness? I mean …

Dr. Mandi: It depends on whether the dog is neurologic or not. I mean I think if you’re worth your salt, you know that. I think that’s where it’s challenging as a pet owner to know. That’s why the first thing I would do is be – you know if I were searching for a veterinary chiropractor for my pet, I would start with my veterinarian and see if they have someone that they recommend and see how they recommend them. Are they saying, “Well, I’ve heard of this guy,” right?

If they’re saying, “Oh, you know, I’ve had clients who have worked with so and so and have been really happy,” or “I’ve met this person and she’s lovely.” You know, those kinds of things. If your vet doesn’t know, then I would be talking to holistic practices and saying, you know, “Who do you recommend for chiropractic?” or talk to horse people and see who they recommend for chiropractic because many veterinary chiropractors that do horses also do small animal. So that’s an option too.

Jim: Aside from the chiropractic modalities, before we were talking – before we started recording, we were talking about all sorts of things that rehab encompasses from e-stim to water therapy to massage. What other rehab modalities might address the compensatory issues that develop after an amputation?

Dr. Mandi: Yeah. So certainly teaching a client how to do exercises is so, so valuable because that dog has – even if it’s not new to them, that dog has compensatory patterns or is learning compensatory patterns and we want to help them avoid some of the things that potentially could lead to further injuries.

A good example would be a dog that has lost a hind limb. We want to be sure that they have a nice tight sit on their opposite leg rather than a lazy sit. If they’re developing a lazy sit, then when they go to get up, they’re more likely to be putting abnormal pressure on their knee and then towards a cruciate problem, an ACL.

Exercise I think is so important. Core particularly. I mean we all hear about core for people but when you are a tripawd, your core becomes so important.

Dogs tend to think of themselves as a frontend and a backend and if we can make them a third instead of a half frontend, backend, you know, versus backend, core, frontend, they now have that much more help, that they can be giving to the area that’s missing a limb. So those exercises are really important and that the owners continue with them, finding a way to keep them part of their regular life.

Very few of us can set aside 20 minutes a day and be like, “I’m going to do PT.” So it really becomes like what can we incorporate into your walk? Can we do five sit-to-stands before you have breakfast? Can we weave between treats on our walk?

You know, finding ways to incorporate that into their regular life. So I think therapeutic laser is very, very helpful. People call it cold laser because muscles get mad when they’ve moved around or you wiped out. I mean if you got three legs, you wipe out. You do it and so if you have four legs, you wipe out.

Therapeutic laser for helping those areas that are working extra hard. Massage I think is fantastic. Just getting those tissues, remaining those tissues supple and sliding past each other nicely and if a client can do nothing else, regular walking is so important. The dog needs that to maintain that steady gait and, you know, nice stretching of the muscles, but also for their brain. Dogs needs to go outside. They need to smell. They need to do all those things even if they have three legs, as you well know.

Rene: Well, when it comes to walking, how does somebody know if they’re walking their dog the right amount when the dog has three legs? Because we get that question a lot.

Dr. Mandi: So usually, I used to tell people to start out. I mean assuming we didn’t have a big walking regimen before whatever happened. Five minutes a couple of times a day and then the next week do 10 and the next week do 15 and what we’re looking for is, “Are we the same speed on the way there as on the way back or are we dragging by the time we get home and then also what does it look like a few hours after when the dog gets up or the next day when the dog gets up?” Is the dog, you know, “Err!”

You know, not necessarily making noise but struggling or seeming sore or slower to get up or excessively stretching, those types of things. You know, a couple of hours later and I encourage owners to keep logs of what they’re seeing. You know, my friends laugh at me that I’m always asking the client, “Are you keeping a log?”

But because sometimes especially when we’re dealing with a new situation for the dog, subtlety is important. Anyway, and then keep increasing as to what works with you. Yeah.

Rene: If somebody were a new Tripawd owner, the dog just had surgery and stitches are out. When would you start this walking routine?

Dr. Blackwelder: I mean even before stitches are out, if we’re using a sling or a Help ‘Em Up harness, something like that, like I think those five-minute walks are great because again, that dog just had something serious happen.

They need to get out and do their normal stuff and smell the smells and go outside and also figure out like bathroom breaks. That gets adjusted when you’ve lost a limb. Like how do I squat? Even in a front leg. Like how do I adjust my – you know, a bathroom is a big piece of being a three-legger and so having a routine where you go outside and you smell the smells, I think that’s really important.

If the dog had had 20 minutes twice a day let’s say before, I would tell them to cut it in half. You know, do 10 minutes. Let’s see how it goes because we’ve had downtime with surgery. The dog is burning additional calories and additional energy just in healing.

Even if they’re gung-ho, we need to come back just a little bit and I hesitate to have them hike for the first probably month, month and a half until we know because that’s different footing, right? And while that’s fantastic for challenging your balance and learning how to use your leg, we don’t want to overdo it with hiking. So easy walks for the first month or so.

Rene: What are your thoughts about walking on sand? Because we probably took our dog out way too soon after surgery, took him to the beach and basically carried him back to the car.

Dr. Mandi: Yeah.

Rene: What are your thoughts for somebody – you live near the coast. Yeah, you kind of say that.

Dr. Mandi: Yeah. So sand is tricky because just like grass, I mean if you think about when you walk in the sand, like your ankles get tired and so it is a wonderful therapeutic tool to use for short things.

The challenge is dogs love the beach. I don’t care what kind of dog you are. The smells are great. There are dead things to roll in. It’s just awesome.

It is really easy to overdo at the beach. So I would say go to a playground and walk around in the sand but I still would be cautious about the beach for the first – it depends on the dog.

You know, if the dog was a really active muscular dog prior, I would probably say a month, six weeks. But even then, it’s going to be a short trip. You are not going to go spend the day on the beach. That is something you have to work back up to.

Rene: That is some of the most specific walking advice we have got to date!

Jim: One takeaway there for me is to take things very slowly, ramp them up slowly. It all depends on the previous condition and compensatory issues of the dog. But cut things in half. Start at five-minute walks and then ramp those things up slowly while identifying certain issues.

Dr. Mandi: It’s always easier to go up slowly than it is to repair the crash, right? It’s hard. I mean it’s hard especially, you know, your dog wants to go. Most of these guys are like, “I don’t care. I got three legs. Let’s just go.”

The owner wants to do something nice for their dog because they’re feeling bad that they lost their leg and in those situations, I would say instead of going to the beach in that first month, buy your dog a dog toy and let them be digging around and getting treats out of the dog toy and things like that before we add too much because it is easy to overdo.

Jim: It comes back to what you mentioned about the importance of developing the core strength and maybe you can correct us if we’re wrong here but one thing I tend to tell people is that walks alone won’t develop the strength necessary to compensate for the loss of a limb. So work in exercises as well.

Dr. Mandi: Yeah. Exercises and also, you know, with an appropriate timetable, different surfaces just like we talked about. So, you know, going for a walk in the grass is a whole different situation than going for a walk on the cement. Cement is very predictable. Grass is not so predictable. It can be squishy. It can be lumpy and so – and then hiking, you know, you’ve got different surfaces and you’re stepping over things. So all of those things are valuable and contribute to core and strength. We just have to take it slow.

Jim: I forget which therapist it was that we interviewed that mentioned walking along a slope. So a fairly inclined slope and not going up there but walking along it and then turning around and walking along on the opposite direction puts different weights on the dogs.

Dr. Mandi: We call those zigzag hills. Yeah.

Jim: There’s no one size fits all for all dogs.

Dr. Mandi: Right, and that is especially true of a Tripawd just because it’s so dependent upon the shape of the other limb, right? And the overall shape of the dog. There are chubby dogs that – our coach potatoes that that’s a huge skill to do a zigzag hill versus a young border collie that was doing agility and got hit by a car, right? Like that’s a whole different scenario. Yeah.

Rene: Well, as everybody can see and hear here is that every situation is so different and you can’t really apply a one-size-fits-all approach to Tripawd recovery and life afterwards.

So again everybody, that’s why we encourage you to go see a rehab therapist. Get reimbursed for your very first visit. Tripawds Foundation can reimburse you up to $200 if you get your new Tripawd evaluated by a certified practitioner.

Dr. Mandi: Good idea. One more thing that I wanted to mention when it comes to modalities. The underwater treadmill, that’s everybody’s favorite thing because it’s cool. But the underwater treadmill can be very challenging for Tripawds because as any treadmill, the underwater is a little bit easier because they’re buoyant. But if you think about for yourself, if you were a four-legged thing and you went to walk on a treadmill and now you’re a three-legged thing, like you have to make huge adjustments.

So a couple of things. One is I would never – and this is true for four-legged animals too but be asking questions about how they work with the dog. Is there somebody in with them? Is the dog cross-tied in the underwater treadmill?

If they’re cross-tied, that gives them a whole lot less ability to kind of adjust themselves and with a Tripawd, they have – especially a four-limb. They have to do a lot of up and down. So I don’t like them cross-tied in the underwater treadmill.

Rene: Can you describe cross-tied?

Dr. Mandi: Cross-tied is they’ve got a float coat on and then they’ve got some – like bungee situation that goes to the side, so that they can’t go too far back or too far forward.

Rene: OK.

Dr. Mandi: There’s value to that and when it’s done right, it can work. But for Tripawds, I think it’s challenging and it makes what is already tricky trickier. And then I play with, with my Tripawds, I play with the incline of my treadmill. So sometimes, say a four-limb amputee, sometimes those guys do way better going uphill a little bit because their power is in the back, right? So they can push and figure out the tread.

Sometimes that same dog going downhill is better because when they’re tipped downhill, they’ve got more water in the front and they’re more buoyant in the front.

When I do underwater treadmill, when I’m talking to a client, with a Tripawd, and we’re talking about underwater treadmill, I always say underwater treadmill is not for every Tripawd dog. There are dogs that it’s just that pattern is too hard, in which case let’s find another modality. They don’t have to do it.

But that we try it. We do make multiple adjustments and then we stick with that for that dog. So it’s not always the best modality for Tripawd dogs even though we think the buoyancy would make it fantastic. The tread being a steady movement the whole time is tricky for a Tripawd dog.

Jim: Could we talk real briefly about the difference between the underwater treadmill and swimming? Because I understand that the treadmill helps them reach for the bottom and it’s teaching them some better extension. But then you get the people who go, “Oh, I will just take my dog swimming,” and they take the Chuckit! and the dog sprints out in the …

Rene: This is what we did with our first tripawd, to be fair. We did the exact thing.

Dr. Mandi: Yeah. Hindsight is 20/20, right?

Dr. Mandi: Oh, I hear you. When I first learned about psoas injuries, I had been a veterinarian for like 15 years and I was like, “Oh, how many of these have I missed?” Right? So I mean we all get that. Hindsight is 20/20. So swimming is a wonderful exercise for dogs who can handle it, musculoskeletal, cardiovascular-wise. So if you are not in good shape, swimming particularly in a natural place where the water might be cold, that could be really overwhelming to the dog.

Swimming is something else that we kind of have to creep up on. Walking in water. So, you know, walking along the shore, same thing. That can be great because that drag is really good. But we just have to be paying attention to the overall condition of the dog.

From a swimming standpoint, three-legged dogs love to swim for the most part because they’re back to being a four-legged dog in their head, right? They can propel themselves so nicely and it’s low impact.

That’s great for those joints that are now carrying 25 percent more weight and if a dog was a swimmer before, I feel that they can go out and start swimming – you know, I mean we’re not going to use Chuckit! We’re going to start small. Maybe just, you know, toss gently. You know, a month, two months in. Obviously depends on the condition of the dog.

But if this is a dog that swam all the time before, which if we live right on the Columbia, everybody chucks the ball in for their dog, and swimming in a controlled situation like in a swim gym or any underwater treadmill, our purpose there is also for that reach.

How much extension can we get? So when you’re a three-legger, you have to keep everything underneath you so you don’t fall down, right? So when you’re exercising or walking, you’re not necessarily really extending those shoulders or really extending those hips because you don’t have time.

That’s where swimming can be very helpful in a controlled situation. Swim gyms, if you have somebody who is experienced and knows what they’re doing and this is where certification is lacking. There is no certified swim person in the United States that I know of. There is one in the UK and so again, talk to your friends who do agility in a show and they’re the ones a lot of times that are going to have a sense of who has got their act together or somebody – but then it’s part of a rehab program, which again pools our – you know, not in every program. They’re not in mine.

We do swim in the underwater treadmill and then the underwater treadmill where it is helpful is that it allows the dog to have that extra time to get a longer stride. So again we’re kind of getting that stretch and working the full extent of the muscles that were not necessarily getting on land because we have to keep our weight underneath us so we don’t fall down. That answered your question, I hope.

Jim: Perfect explanation. Thank you.

Rene: Perfect. And, you know, Dr. Mandi, I could talk to you all day.

Dr. Mandi: That’s what I do all day.

Jim: Well then, let’s do this again.

Dr. Mandi: Let’s do it again! I’m all for it.

Rene: Dr. Mandi, thank you so much for being here. We could go on all day but we’re going to instead have another episode with you!

Dr. Mandi: All for it and I love my three-leggers. I love them. They’re heroes. I love them.

Dr. Mandi: OK. I don’t know if you already do this but one really great piece of advice for your people post-op is to put a note on the door that says, “Dog recovering from surgery. Do not ring bell. Text me.”

Rene: I love that.

Jim: Many thanks to Dr. Mandi and the work she’s doing to help keep our three and four-legged friends healthy and strong. If in the Portland area, make an appointment with Dr. Mandi for help with your tripawd or visit for more information. Don’t forget that the Tripawds Foundation can pay for your first visit with Dr. Mandi or any certified rehab therapist. Get details and help finding a therapist near you at

[End of transcript]

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