Introduction: Welcome to All Cats Considered, a podcast from the Feline Veterinary Medical Association.
Here we interview professionals from across the veterinary world and take deep dives into the latest evidence-based research developments, studies and guidelines that improve feline health and well being.
We are the home for veterinary professionals seeking to enhance the care of cats through high standards of practice and continuing education and evidence based medicine. In each episode you'll hear interviews with a variety of experts in our field covering a wide range of topics and the latest developments in feline health. We'll share the key points you need to know to improve your patients care.
Let's dive in and listen to this week's experts.
[00:00:44] Dr. Kelly St. Denis: I'm Dr. Kelly St. Denis and welcome to our podcast interview. This month we are talking to Mary Ellen Goldberg, veterinary technician extraordinaire. I would like to say we're going to talk to her a little bit about all the those initials after her name and we're going to be talking about the two articles that she wrote for our Journal of Feline Medicine and Surgery Pain Management special collection. And the first one we're going to be talking about this month is Physical Rehabilitation of Cats. Part one is Common Conditions Benefiting from Physiotherapy. And you'll be able to find that publication at the Journal of Feline Medicine and Surgery open access in the month of July of 2025.
Welcome Mary Ellen. It is so much a pleasure to have you here with me today.
[00:01:29] Mary Ellen Goldberg: Thank you very much, Dr. Kelly. It's a pleasure for me.
[00:01:34] Dr. Kelly St. Denis: We've known each other quite a long time and interacted at various things and I was just so excited when you were submitting these articles to the journal just to see what was coming out with this. Physiotherapy is such a, such an amazing thing. So I just want to congratulate you on both articles, both this one today that we're going to talk about in part two, which is treatment therapy on, on the actual treatment options and, and we're going to see these, that one in September on the Journal of Feline Medicine and Surgery and we'll have another interview that we get to talk about that one separately.
So yeah, congratulations. That was a lot of hard work I think.
[00:02:08] Mary Ellen Goldberg: Thank you very much. And I have to give a plug to Dr. Mark Epstein who's the editor of this special collection because he's the one that asked me, you know, he's the one that possibly suggested me or asked me to do this.
[00:02:25] Dr. Kelly St. Denis: He did.
[00:02:26] Mary Ellen Goldberg: It's an honor for me because this is in my opinion it's a prestigious journal, and so I'm very honored to be able to have submitted two articles for it.
[00:02:41] Dr. Kelly St. Denis: Yeah, we were very excited to have you write them, so thank you.
So these two articles have a lot of practicality for veterinarians in practice and veterinary technicians as well. And I just wanted to talk a little bit about you and how you. What's your history in terms of you're a veterinary technician, but you do so much. And I. I just mentioned all the initials after your name, for example. Can you tell us a little bit about your history and where you're at with your career right now?
[00:03:10] Mary Ellen Goldberg: Right now. It's why my career is winding down. I don't mind admitting I'm 68, and so I'm not in a practice every day any longer. I'm majorly an independent or major or the majority of the time, I'm an independent consultant. I graduated from Harcombe College and the University of Pennsylvania in 1976. So that's ancient history. But I graduated and I was in the second.
Virginia had Virginia state boards.
There was no national exam for veterinary technicians when I graduated, it was that early.
And so I took state boards and I passed in June of 1976 and immediately started work. I went from practice to a research company that is now folded. It was AH Robins pharmaceutical company.
And I went to work at a research farm that they had and it was for chickens. And we worked on a Coccidio stat for chickens. I love chickens also.
So we were. I worked there and it. So the pharmaceutical industry.
And then I got pregnant and I had my first child. So within five years I had three boys. And then I stayed home for nine years before I went. Because to be quite honest with you, to be quite honest with you, even back then, childcare for three children, you had to make some kind of phenomenal salary.
And veterinary practice, they just, you know, it just couldn't afford it. And so I understood this, so I stayed home. My husband, you know, he was the sole breadwinner. I was the babysitter, which was fine.
After nine years, I went back to work and I worked for eight years then at a mixed practice.
So I loved working with cows and sheep and goats and pigs, and it had dogs and cats and anything that somebody would bring in, we worked on.
So then after that, I found a job in the local paper in 1996.
The ad said animal technician.
It was down at the Medical College of Virginia, Virginia Commonwealth University.
And so I thought, well, let's see how this goes.
So I went down and this was before computers. I mean, there were computers, but not everybody had one in their home. So I had to go down there and fill out a big, long application, but which I did, and they called me. It was six weeks before they called. I mean, I kind of had forgotten about. Not forgotten, but thought, well, I'm not going to hear anything.
After six weeks, I got an interview.
Went down for the interview. The next day, I got a phone call that they hired me. They wanted me to start, to be quite honest with you. And it's not private practice's fault. The salary was, like, exponentially larger than what a private practice would offer, plus benefits such as medical insurance for my entire family. So the boy, you know, for the boys, paid vacation, paid sick leave, which was something years ago that just wasn't off. A small place could not do this. So anyway, it was there that you.
[00:07:20] Dr. Kelly St. Denis: Kind of got involved with anesthesia and pain management, isn't it?
[00:07:23] Mary Ellen Goldberg: Exactly. I mean, when I went down there, because my main function was doing anesthesia and pain management for the researchers.
I did other things, you know, for the animals. But it was all kinds of species, you know, mice, rat, birds, ferrets, rabbits, dogs, cats, monkeys, which I'd never worked with before.
I mean, it was just frogs, anything fish. I studied a huge amount for that.
And that is when, while I was there, that I became interested in pain.
I took nurse anesthetist courses.
Now, when I took them, I had to audit them.
The reason being is in order to take them, to get credit, you had to be an rn, you had to be a nurse.
And I was not allowed to touch people. I wanted to intubate people so bad. You know, I was in the lab and I was watching them do people, and I was just like, I could do this, I could do. But I didn't because I hadn't been legal.
So anyway, so then I became involved with the International Veterinary Academy of Pain management.
[00:08:54] Dr. Kelly St. Denis: Yes.
[00:08:55] Mary Ellen Goldberg: And Dr. Bob Stein brought me on board as the executive secretary.
And I was that for them for 10 years.
And then it grew and grew and grew because I went to all their meetings.
And, you know, that's where I met Dr. Jan Van Dyke, who got me involved in physical rehabilitation.
And I don't mind admitting the fact that Dr. Van Dyke called me and she said to me, mary Ellen, you know, I'd like to hire you to do some things. I said, okay.
And she said, but, you know, would you be interested in going through my certification school for veterinarians and Technicians for rehabilitation.
She said, I'll put you through.
The cost was more than I could have afforded to go through most places, send their veterinary technicians or assistance and put them through.
Whereas I was at that point an independent contractor. In 2012, I was working at Lion Country Safari.
So that's zoo animals and stuff. But she said to me, I'll put you through. Which she did.
So I became certified in rehabilitation.
And then it was from there that I was on the organizing committee to help develop the vts and physical rehabilitation.
And I was on the organizing committee to help with the VTS for lab animal medicine. They have several segments for that and mine was the anesthesia analgesia one.
And I had also gone through credentialing for surgical research anesthetist because there's a certification that for surgery in research, veterinary technicians are allowed to do surgery.
It's specialized.
And so there are surgical procedures you're allowed to do under your veterinary auspices staff, you know, and because I knew about this from being in research for 15 years, then I just, I thought, well, this is a natural. So I went for that.
And then I went for the certified veterinary pain practitioner through ivapm.
My case studies were all on non human primates because everyone did them on dogs and cats, which is understandable what you are in practice with.
But I did mine on non human primates from research and from Lion Country Safari. So it's been an expansive journey for me.
[00:12:10] Dr. Kelly St. Denis: For anyone listening to this, these are all these things that Mary Ellen is explaining. These are all these initials after your name, all of these things that you've done. That is so, so cool.
[00:12:21] Mary Ellen Goldberg: And the only animals I have never worked with, I've worked with penguins, but I have never worked with marine mammals, whales or dolphins. I've, I've swum with dolphins, but I've never worked with dolphins or manatees.
[00:12:41] Dr. Kelly St. Denis: Maybe that's something you can do as a hobby.
[00:12:43] Mary Ellen Goldberg: I know, I know.
[00:12:46] Dr. Kelly St. Denis: I mean, this article is so amazing because it really focuses as all of us at the Journal of Feline Medicine Surgery are focused on our feline species.
And I just thought maybe we could start with the basics. Like we talk about physiotherapy, but maybe you can just tell us a little bit, what is physiotherapy and what are its potential benefits to cats? Like, why are clinicians going to be interested in reading these two publications?
[00:13:11] Mary Ellen Goldberg: Publications. Well, first of all, in addressing the first publication, it helps to outline conditions.
[00:13:22] Dr. Kelly St. Denis: Yes.
[00:13:23] Mary Ellen Goldberg: That cats can develop or have where physiotherapy Would be helpful. Physiotherapy, or physical rehabilitation, as they call it in the United States, that is helping the animals, number one, I feel quality of life.
So as they are aging, it helps them to be able to move, to be able to. It tremendously helps with pain.
And so much because I was in a human aspect for research, I think of why do physicians send their patients to have physical therapy when they see them after a surgery? Anything like that helps them to move, help them to get back to a normal way of life, helps them to not have pain with their life.
And as they age, you can help them to have a more mobility, a happier quality of life. I look a tremendous amount also. I do this.
I compare my thoughts of human patients with my thoughts of animal patients because they're very similar. I mean, yes, yes, there are differences, absolutely, but there's a lot.
The more you study and the more you read, the more you realize how closely connected we are.
And I believe that's why one of the definitions for pain that the International association for or AIA International association for the Study of Pain developed is that pain is not just limited to patients that can speak, but they now include non speaking.
Whether that's patients that are unconscious, whether it's patients that are babies that cry, you know, pediatric pain. But it includes all our non human animals. And so the fact that they cannot speak does not negate the necessity for our knowledge of pain management.
And one thing back to the physiotherapy is that I find that we need to look at it as part of complete veterinary medicine. And there are going to be people that are going to say, well, I can't do that. And that's understandable, you know, if they feel. But if you want to offer the complete packaged to them. And more and more people are looking at their pets as their fur babies.
When you have this, you think, well, if my child couldn't walk, would I just go, well, I can't do this?
You know, there are ways. There's so many ways that you can help the clients to do things at home.
So even if they can't bring them in all the time, and often they can do things and have an exercise program at home.
I get excited about things like that.
[00:17:10] Dr. Kelly St. Denis: Yeah, no, I love it, I love it. And I started to take. Well, it's an overused word, but I try to take a holistic approach to my veterinary practice. I mean, practice still two days a week. And this is part of that, including obviously pain management and pain recognition. But this is part of that holistic approach. I really like that you kind of touched on the similarities with humans and potentially cats. But one of the major differences, of course we know is that cats are not always amenable to interactions and handling.
And you talk about myths about cats and physio. So I wondered if we could talk a little bit about that and you know, where cat friendly interactions and handling come in. To dispelling the myths behind cats and physiotherapy.
[00:17:52] Mary Ellen Goldberg: It's imperative if you're going to do physiotherapy. It's not imperative necessarily, but although with the fear free approach, it's getting more and more that way. But it's imperative if you're going to be trying to do physiotherapy with cats that you want to have excellent behavioral skills, behavioral knowledge and handling skills of cats.
Because the saying less is more could not be more true.
Our dogs, and we need to think of it in terms of sometimes you can have your dog in physical therapy.
It's not. Physical therapy is an incorrect term.
We have to train ourselves to. Physical therapy is a human term, just like nurse. And so it's protected. And in veterinary medicine we're not allowed to use it. That's why we use physical rehabilitation or physiotherapy.
We cannot use physical therapy, although I think of it interchangeably all the time with dogs. Sometimes we can prod them along, sometimes we can help them. If you're doing specific exercises that you have hands on them and you want to move something, well, the one thing that is absolutely true is if you've got a cat that's having pain, whether it's from osteoarthritis or from an injury, a trauma or hip dysfunction, whatever, if you've got a. Or a neurological pain, if you've got pain and you want to try to get them to do something, they're not going to do it if they hurt, they're just not.
And so. And one of my mentors that taught me this is Dr. Robyn Downing. Yes, she taught me years ago, you're not going to get them to do anything if they are hurting.
And if you try to make them do it and they're hurting, that's the last time they're going to do it. That's it. There are things that, if it's a younger animal, sometimes you can give them a pre a dose of gabapentin or you can have the pheromones in your practice to help them not be upset.
And now there are Techniques in physiotherapy that you can do to help with pain management.
I am allowed to assist with it, but I am such a big believer in acupuncture, I just cannot. Even so, you can have an elderly cat that has kidney disease and liver disease, they can't take drugs. They're that you know, and you can bring them in, give them acupuncture, you can use laser photomyobodulation biomodulation on them. So you can use laser therapy, you can send home a pulsed electromagnetic field therapy which is like the Assisi loop. And you can do these things to lessen their pain prior or prior to starting any type of physical exercise.
[00:21:46] Dr. Kelly St. Denis: And that kind of helps with minimizing the pharmaceuticals you might need to use for analgesics if the patient especially like you said, has contraindications.
[00:21:55] Mary Ellen Goldberg: Absolutely.
[00:21:57] Dr. Kelly St. Denis: Yeah.
[00:21:58] Mary Ellen Goldberg: The other thing that Dr. Downing taught me, you know, you can, if you start them, if they're young enough and they have their lab values are good enough, you can start them on a multimodal pain approach there of medications.
And then when they come for physical, for physical rehabilitation, they're. They're more relaxed.
[00:22:25] Dr. Kelly St. Denis: Yes.
[00:22:26] Mary Ellen Goldberg: You know, they're, they're easy. And when you start with them, the other thing is dogs. You know, you can push dogs a little bit and dogs tend to want to please.
Cats don't care whether they please or not for the most part. And so you have to be willing absolutely to change up your program if you bring them in one day and you have it all planned out that you're going to do a specific thing and if that day they happen to be in a bad mood and they don't want to, well, maybe you can do some massage, maybe you can do some of the therapeutic laser. But I mean, you have to be willing to change up your plan.
[00:23:17] Dr. Kelly St. Denis: And I think a lot of us are learning cat friendly handling and interactions and understanding feline emotions. That's kind of. We also do that in our physical exam. I know like, you know, just even a complete physical examination will vary from cat to cat depending on what their emotions are and their behavioral responses to those emotions. So it's just like you said, you can't push them. You have to adapt your own needs to the cat, the cat's emotions.
[00:23:42] Mary Ellen Goldberg: And, and I look back on it over, well, just about. Well, I worked at a veterinary practice prior to going to college in a way. When I was in high school, I worked at a practice because I just loved it so much. So anyway, but I mean, so over 50 years of working in veterinary medicines and practices and things, things have to changed, you know, much for the better too. Yes, yes. It used to be, you know, you had a cat come in and it was nasty. And it wasn't just that way with cats, I have to admit wholeheartedly it was that way with dogs. I can remember even after college having. And one of the things that, I mean, I cringe when I think about it, we had dogs come in that had these chronic ear infections.
They were, well, they were aggressive and they were nasty and why? Because they were hurting so bad nobody cared to address the pain. And back in the 80s and 90s, the only drug that was out there now, morphine was there, but veterinary practice didn't really have it. Butorphanol could be used for dogs and cats and did they give anything like that for these horrible painful surgeries? Think of all the nerves up in the head and the facial nerve and every. And when I think now about it, I, I literally just want to cry at the thought of the pain that animals were put through for no reason at all.
And I think about cats, you'll remember it. Cats come in for physical rehab because they've been declawed and it's a declaw gone bad where they now have neuropathic pain in their feet because they didn't have proper pain management after this. And see, I'm now all for the no declaw thing. And I don't, I think in Canada they don't do them anymore. Isn't that correct?
[00:26:10] Dr. Kelly St. Denis: For the most part in most places, yeah. We're seeing it moving away from commonplace to almost band in most of Canada. So yeah, and it's, it's amazing to talk to someone like you with your extent of experience over the years with all the different species, but especially of course cats and how everything that you've experienced with this pain has rolled into things like this article.
And we're actually kind of out of time in our talk. I've been enjoying chatting with you.
[00:26:40] Mary Ellen Goldberg: I'm sorry, I'm. I'm sorry.
[00:26:42] Dr. Kelly St. Denis: No, don't be sorry, this has been fantastic. Again, I love learning about your experience and how it rolls into the physio for cats. A physical rehabilitation for our listeners. This particular part one of this, this two-part series, Mary Ellen discusses the conditions that are amenable to or benefit, will benefit from physical rehabilitation. So those include osteoarthritis, degenerative joint disease, fractures, neurologic conditions, cats that have had femoral head and neck excision and also weight reduction for obesity, which is a big one, right? Because we know this is like over 50% of cats have either overweight or obesity.
And I think the stats in New Zealand are something like 60.
So for sure go and have a look at the article.
We're going to say in the article.
[00:27:33] Mary Ellen Goldberg: I talk about learn how to think cat.
[00:27:36] Dr. Kelly St. Denis: Exactly.
[00:27:37] Mary Ellen Goldberg: And so it will be helpful in prioritizing your therapies.
[00:27:43] Dr. Kelly St. Denis: Yeah, I love that.
[00:27:45] Mary Ellen Goldberg: I realize think cat is not really a technical term or used in any way, but I say that because it helps us to learn.
[00:27:59] Dr. Kelly St. Denis: It does.
[00:28:00] Mary Ellen Goldberg: There's, it's, it takes a special thought process for their behaviors.
[00:28:05] Dr. Kelly St. Denis: It does. It rolls the cat friendly right into all of these things. So also, I want to thank you for making that practicality about this too, because it does really help everyone when they're reading this for from a practical point of view.
[00:28:15] Mary Ellen Goldberg: Right.
[00:28:16] Dr. Kelly St. Denis: To think cat. I like that a lot.
So thank you very much for joining us today, Mary Ellen, and we're going to talk again in our next episode talking about part two of this article.
So I will see you again.
[00:28:31] Mary Ellen Goldberg: Thank you so very much for having me.
[00:28:33] Thank you for listening to this episode of All Cats Considered. We hope you enjoyed this interview. For more information on the topics discussed in this episode, please head over to catvets.com podcasts and explore the links in the show notes. Don't forget to subscribe to this podcast on your platform of choice so you won't miss any episodes as we release them. Have thoughts or ideas about the interview you heard today.
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