Mani, a five-year-old male tamandua at the San Diego Zoo Wildlife Alliance, was beginning to slow down. Though only middle-aged, Mani had trouble climbing, exhibited limb stiffness and difficulty pulling his body up from a tail hang, and moved more slowly when descending a sloped perch. His keepers also noticed a couple of concerning falls. “A CT scan revealed Mani had caudal lumbar spondylosis deformans and spondylosis in his cervical and thoracic spine as well,” says senior veterinarian Deena Brenner, DVM, DACZM. “I performed a mobility assessment and saw [Mani] had moderate stiffness in his rear legs; mild kyphosis at the thoracolumbar junction; and stiffness in his hips with decreased extension, especially when standing. He was also slow and deliberate in how he used his tail.” Mani, one of the zoo’s most popular ambassador animals, was referred for physical rehabilitation to improve his strength, function, and mobility. “We started him on a variety of exercises that included the vertical weave, which is a series of vertical poles he has to walk through; Cavalletti rails, which are raised obstacles on the ground that he has to walk over; and a tunnel, which promotes spinal extension,” Dr. Brenner says. “He also uses a balance board and equipment like an incline ramp.” After seven months of physical therapy, Mani is more like his old self. “The wildlife care staff reports he’s doing very well,” says Brenner, who has a specialty certification in veterinary physical rehabilitation. “He is moving more comfortably with a stronger rear-limb posture, he’s not slipping, and he hasn’t had any falls. They really feel that physical rehabilitation has particularly helped Mani.” Galapagos Tortoises receiving manual therapy at San Diego Zoo. Photo courtesy San Diego Zoo Photo courtesy San Diego Zoo Mani is just one example of the use of rehabilitation therapy on zoo animals, a modality that has much in common with the rehabilitation services provided by many general-practice veterinarians, according to James Steeil, DVM, DACZM, a supervisory veterinarian with Smithsonian’s National Zoo and Conservation Biology Institute in Washington, D.C. “I can have the same conversation about the treatment of arthritis in my cat and in a tiger at the zoo,” Dr. Steeil says. “The outcomes might be slightly different because of limitations based mostly on safety, but what we provide is eerily similar to what the general practitioner is doing in terms of diagnostics, treatments and collaboration with specialists.” “What is always amazing to me is how translatable many canine rehabilitation techniques are across zoological species,” Brenner adds. “They just need to be adapted to the body of the patient. We know bodies age similarly, and the care for those is similar, such as analgesics, exercise, and range-of-motion activities.” Zoo animals receive exceptional care, so they tend to live longer in managed care than in the wild. As a result, age-related joint conditions such as osteoarthritis are the most common reason zoo animals are referred for physical rehabilitation. “We commonly see arthritis in the spine, hips, stifles, and elbows, similar to dogs and cats,” says Brenner. “Physical rehabilitation after injuries and post-operatively are also important in zoos.” At most zoos, the veterinary staff and the animal care specialists–the individuals who work daily with the animals and know them most intimately–work collaboratively to identify issues that may require rehabilitation therapy and create a treatment plan. “Animal care specialists have a really good eye as a result of their relationship with the animals under their care,” says Jennifer McGee, director of Wildlife Experiences at Brookfield Zoo Chicago. “These animals are our colleagues. Many times, we work with them throughout their entire lives, which builds deep, respectful relationships.” Animal care specialists are also involved in training the animals to voluntarily participate in their own health care by presenting their bodies upon request and cooperating with physical examinations. The key, says McGee, is building trust, so animals are trained using positive reinforcement. When an animal completes a requested behavior, it is rewarded with food, a toy, or even a pat on the head. Behaviors are broken down into small steps so the animal can learn one piece at a time until the behavior is complete. “Because welfare is our top priority, it’s important an animal have a choice in their participation, and it’s a positive experience for them,” McGee says. “It’s all about making learning fun.” A good example of care training is Mandara, a 44-year-old female gorilla at the Smithsonian’s National Zoo, whose animal care specialists noticed was slowing down a bit, and shuffling her feet more. Mandara had been trained to present her feet for an examination, which made the diagnosis of arthritis in her ankles much easier, along with her physical therapy. Rehabilitation therapy is not for all zoo animals—some species are too small or fragile or find the process too stressful, but the array of animals that can and have received therapy is impressive. One interesting injury case at the San Diego Zoo is a female aardvark named Zola, which sustained a neck injury when she was young. As part of her rehabilitation therapy, Zola participates in therapeutic exercises twice a week and receives analgesics, acupuncture, and manual therapy. “We also have three geriatric Galapagos tortoises who receive manual therapy every week for osteoarthritis,” Brenner says. “We use the shell like we would use the ribs and the spine to move the body in different planes, and we also use manual massage therapy on their limbs.” At Brookfield Zoo Chicago, a female leopard tortoise named Kaya has been receiving rehabilitation therapy several times a week to treat a spinal deformity that made defecating difficult and caused weakness in her hind legs. Kaya’s treatment includes core stabilization using a balance ball (with assistance from her animal care specialists), an obstacle course that requires her to lift her legs to navigate, and an incline for strength building, says McGee. One of the more intriguing rehab cases at Smithsonian’s National Zoo was a popular male Komodo dragon named Murphy, who was diagnosed with arthritis in his joints. Dr. Steeil partnered with Matt Brunke, DVM, DACVSMR (Canine), CCAT, a veterinarian who specializes in canine sports medicine and rehabilitation, on a plan that included injecting Synovetin OA, a radioactive isotope developed for dogs, into Murphy’s joints to curb swelling and inflammation. “We had established a rubric to evaluate Murphy’s mobility, gait and joint flexion, which showed that he gained improvement in his comfort level as a result of the therapy,” Dr. Brunke says. “Unfortunately, Murphy’s joint issues worsened as he aged, despite rehabilitation therapy, and the decision was made to euthanize him in December 2024.” Radioactive isotopes are just one weapon in the veterinary arsenal for rehabilitation therapy in zoo animals. Other common treatments include epidural steroid injections, cold laser therapy, shockwave therapy, and, of course, therapeutic exercises. “Whether you’re a human physical therapist or in the veterinary rehab world, these are all approaches we can use as targeted therapy for arthritis, tendinitis, and other painful conditions,” says Dr. Brunke. As for equipment, radiography and CT scans are vital, reports Brenner, as are physical exams, goniometry and muscle girth measurements. Exams in various forms are used to establish health baselines, aid in diagnosis and document treatment progress. Zoos with rehabilitation programs commonly share research findings with the greater veterinary community via journal articles and medical conferences. In many cases, however, information trickles down to general-practice veterinarians and pet owners via promotional videos produced by the zoos. Smithsonian’s National Zoo, for example, produced a 2 ½-minute video about Murphy titled “How Do You Help a Komodo Dragon with Arthritis?” “Within a month of the video going live, I received four specific consults from people who wanted to discuss Murphy’s therapy for their pets,” Dr. Brunke says. “Many of them also asked, ‘Is this approach available for me, because my knee hurts.’ I had to tell them, no, but there are other things you can do.” “We tell a lot of stories like these at the San Diego Zoo, and I think they inspire people to think about how to treat their own animals,” notes Brenner. “There are a lot more physical rehabilitation opportunities for small animals than there were just five years ago, and I think community veterinarians will be asked for rehabilitation therapy more as a standard of care moving forward.” Don Vaughan is an award-winning writer who frequently writes about veterinary topics. His work has appeared in Writer’s Digest, The Saturday Evening Post, Cure Magazine, and Encyclopedia Britannica.
