Deborah Carroll's Blog, page 12

Zoe, Great Dane Hip Surgery; Setbacks, Exercise

Hi Deborah – Hoping you can give me some exercise and muscle building tips for our great dane Zoe. After her hip surgery to repair the right side femoral subluxation about 9 wks ago, she had a few setbacks, not able to tolerate many meds and attacked by a large dog which we think caused some soft tissue sprain/soreness. Consequently, she refused to use the leg, and now has some significant atrophy in her limb.

We finally got her to tolerate some Deramaxx and using heat, massage, and alternative remedies (herbs, acupuncture, laser), she is using the leg pretty normally now and is feeling MUCH better the last 2 weeks or so. She is up to 2-3 ten to fifteen minute walks a day. Time to try building up some muscle to even out her legs and hips. Any suggestions? Our rehab specialist here says we can start small slopes and cavalettis. Since you know Zoe well, what can you tell me about helping her build her strength and conditioning back up?

Thanks, and we miss you!!!

My Replies:

I know her and I know you guys, so I don’t mind being a little more specific on here for you…but I do wish I were there I really am beginning to think about a trip…I know we have exchanged some texts and emails about her in the past few months…

Did you guys ever find my FHO homework and start on that fairly strictly, beginning at week one? I see that you are taking her on 2-3×15 min walks daily…how slowly? Wedding march or “wagons ho” is the speed I want to see, with consistent walking (no piddle & sniff) and consistent weight bearing. You may be doing that, in which case, I need to know if she seems more lame, lame at all, or not lame after those walks.

If she is not lame at all, then my preference is to advance to 2 weeks of 2×20 min walks before adding in hills. Let me know where you are on that. The most prevalent difference I find between what I say vs what people are having their dogs do is in the speed of the walk. The pain meds help encourage leg use and the slow speed forces individual limb use. She needs that individual leg use to encourage weight-bearing and healing. So, no sense moving on to hills if we cannot get 20 min of persistent, consistent leg use on the flats. Let me know about that and then we will talk about type and frequency of hills. Thanks for the great post!

Filed under: Q&A (Make Sure You Click Link to Older Posts Too) Tagged: dog FHO, dog hip surgery, dog lame after hip surgery, Great Dane hip, Setback after dog hip surgery

Miss M, 12 yo Great Dane with History of Canine Meningitis and Knee Surgery

3/2012

Hi Deborah- Thanks for giving me directions to your webpage. Lots of interesting food for thought. I would like to make an appointment with you. Let me give you a bit of background on our dear girl. Our elderly Great Dane, MXXX, is still hanging in there but over the last month she’s having more and more problems with mobility and her back legs. She’s 12, and had ACL surgery two years ago, soon after we lost her brother (house mate but not litter mate). Aside from her back legs (and hips) letting her down, she’s really very healthy. She also has a history of canine meningitis which gives her a chronically stiff neck. We are able to treat that with acupuncture and supplements for the most part though occasionally a short course of Prednisone has been necessary. Since her ACL surgery she has gone to walk on the water tread mill every other week (sometimes more often)… This has really been a help. She always walks better after a day at physical therapy. I feel like she’s hit a bad spot though. Previously we were able to easily go for two 15-20 minute walks daily. She would sometimes get tired towards the end and I’d have to help her home, but just as often it went just fine. Now she always needs help home every time. She also can no longer get herself up, but always needs help (I have seen her get up on her own when she is very motivated, but I actually discourage her from it as I think it strains her and she tends to get abrasions from scooting to try and get up). Finally the lack of exercise is effecting her bowel movements. MXXX is our “first born love child.” We’ve had her since before we were married and we will do anything we can to make her more comfortable. I thought it might be time for her to have wheels for her back end. Dr. D said that you might have some good ideas for helping her to keep using those back legs to help her keep the muscle she has and help her bowels and digestion keep working. Any advice you have would be most appreciated. Please let me know when you might be available for an appointment.

Regards,

K. M.

Excerpts from the first report from her owner a week after my first visit with MXXX:

“MXXX is doing well on her new food, increased fish oil and joint supplements, and her new exercise regime. She’s doing really well with the 3-4 shorter walks per day. She has also done well with the hills. I have not been as good with the cavalettis. We went to the park and walked over some railroad ties. These were a bit too tall for her. She got over about 5 of them before she got tired and started hanging up on them. We rolled up blankets and walked over them in the house one day, and that seemed just fine. All and all she seems more energetic to me which I really like seeing. She is still pooping only once a day, but the quality of her poop seems better.”

“The massager is kind of a mixed bag.  Sometimes she seems to tolerate it really well and enjoy it. Sometimes it seems to really annoy her.  It’s not clear to me what the clues are yet for when she’s going to accept it vs. when it’s going to annoy her.  Also she tends to lay on one side and not the other so her right side has gotten more massage time than her left.  But we’re working on it.”

and my reply:

That’s a great feedback report.

Yay!

The blankets seem like a good idea until she gets more used to the project. Then maybe some tree branches before railroad ties The railroad ties may always be too big for her…I had one client use a row of several of those folding chairs one takes to sporting events. She had a Golden Retriever, and they were able to do cavaletti work in the carpeted garage. Some people buy things to use from the home fix-it warehouse when I instruct them on what to buy and if we can’t find free stuff that is suitable around the house to use. You don’t usually need to go to a lot of trouble.

Good job keeping up trying the massager. My preference, if you were to get any of it done, would be along the spine to increase circulation where she is probably guarding the most.

I am letting Dr. D know how things are going, too.

Sounds great!

Blessings-

…and from additional comments I placed on Facebook:

She had already done quite a bit of water treadmill walking, but it just wasn’t dynamic enough to improve her neuro-muscular status, at least, not to the degree it could be improved or to the degree that was necessary for better function at this point. In this case, solid program design of land-based drills and exercises that are easy to do in the home environment have made rapid improvements!

Filed under: Q&A (Make Sure You Click Link to Older Posts Too) Tagged: canine meningitis, great dane knee surgery, great dane neurological

Otis, 9 yo Lab Mix With CCL/ACL Surgeries, 2012 and 6/2013 Lame and Painful

Hi my name is Debi. My dog Otis is a mix breed. Lab, shepherd and maybe some boxer or pit. He is 70lbs and 9 years old. He had his first acl surgery last year and his second in June. It was one year between surgeries almost to the day. It took some time last year but we got him to about 85% normal when the other knee blew. We are now about 3 months post op on the second knee and we try to walk a half to a mile each day. Where I live there are some pretty steep hills so we go slow and try to combine hills and flat areas. He has been doing very well over all but in the last couple of weeks he has been chewing on his backside just above his tail. He hasn’t had skin issues or hot spots before so I assume this is a sign that he is having some pain. He is one rimadyal 100mg per day. I am changing joint supplements since he refuses to take what I have. He isn’t on any other prescription pain medication. It is very difficult to sneak pills past him. I am wondering if I should put him back on a low dose pain medication. I am also wondering how much is too much or too little when walking him to rehabilitate the knee. He favors the leg if he is standing and does walk with a slight limp and does a “skip” when he tries to pick up his pace. It’s obvious he still hurts but he meets me at the door and is still wanting to play with our small dog.And he is always excited and willing to go walking. We do keep him contained with regard to free movement. No running, jumping or rough housing with the little dog and all outside activities are on leash. Any suggestions for pain management and a recovery program would be greatly appreciated. I am also on a very fixed income. Thank you for your time. Debi

POSTED BY DEBI BENDER | OCTOBER 7, 2013, 5:23 PM | 

(from my email reply in October)

Hi!

I read your note a couple of times, and after some thought, I really, really want you to get my rehab book…very inexpensive…and start at week two after reading the whole thing through.

The book only covers the first four weeks, but it answers all your questions, and the first thing I’d have you do if I saw you and your pup in person is just what I just said 

I’d also probably discuss pain meds with your vet, but you aren’t in my area, are you?

If you don’t have a Kindle, it doesn’t matter…you can read the book by downloading Kindle for Apple or PC or phone when you go on the site, and it’s free. (and NOW the book is available in paper, and I highly recommend anyone get that version so they may make notes and share easier).

Here is the link for the book, and I promise if you take your time and start there…even though it’s been quite a while, that is the same thing I’d tell you to do, based on what you wrote in your note, if I saw y’all in person.

Trust me.

Guidelines for Home Rehabilitation of Your Dog: After Surgery for Torn Knee Ligament: The First Four Weeks, Basic Edition

Blessings-

Deborah 

POSTED BY REHABDEB | NOVEMBER 19, 2013, 8:49 AM



Debi wrote:  Deborah, Thank you so much for your reply. I have the book. Bought it right after I sent you the message. Great minds think alike I guess. I wasn’t sure where to start so I will start at week 2 and see how it goes. What would the symptoms be if the pain was caused by an infection?  Or is that something I should be concerned about this late in his recovery (3 months)? I will get started tomorrow. Once again thank you so much and Otis thanks you too! Debi
I live in Washington. I found your website while searching for rehab information for the acl surgery. I can’t tell you how much better I feel about going forward with rehab for Otis. I feel like I have a starting place and an idea of what to do and watch for. That is far more help then I have gotten. I’ve had several dogs over the years but this little guy has my total heart.  Thank you so much! Debi

RehabDeb responded:

Thank you-

You are the reason I have squeezed out the time to make the Kindle and now the print versions available. And I have a lot more to publish, so managing time is always a fun sport

I don’t know of any veterinarian or rehab friends I have in your area, so I don’t think I can help you there…unless someone moved and I just didn’t get word.

Anyway,

I highly recommend you read the whole book through, twice, and catch anything you missed, since you are having issues so long with Otis. Surprising what people miss the first time or even the second time through the info.

It’s the basic edition, just 4 weeks of work, but it covers the most problematic time for the animals.

Also, like I said on FB, watch that massage video twice and start doing that. It’s on my website and also on FB under videos (I think). Watch twice. You can get the massager at CVS and I hear through Amazon, too.

Blessings-

Deborah

Debi wrote:

Will do on both re reading the book and checking out the video. We did 3 short walks yesterday and 2 so far today. Shooting for 4 short walks spread out over the day. If you know anything about Washington it is hard to find a flat place to walk. I am using the short dead end street across from my house. It has a slant but not a steep hill. We are taking it slow. Started him back on tamadol today 25 mg 3 times a day along with rimadyl and joint supplement. I have a call into a new vet to see about changing to the gabapentin. I’m sure that will require a full exam (costly for a single mom on a small income. But the surgery was expensive. I’m not going to spend all that money and then blow the rehab!) Any way that will give me a chance to talk about possible infection etc. I feel bad for taking up so much of your time at not cost to me. But as I said I would do anything for my guy and you’ve been an invaluable resource. Have a great day! Debi

RehabDeb responded:

Another thing I’d get local clients started on is an anti-inflammatory diet, because so many foods cause inflammation, especially when there is already an injury…then the inflammation can go straight to the injury site, too.

I talk to my clients about using Wellness Core kibble and eliminating the treats altogether. Most of the animals I see are carrying too much fat, especially to be injured or challenged physically. Get off all treats and use kibble as a treat. Use Wellness Core canned food to give medicine if you have to. Get away from peanut butter, pill pockets, etc…If you dont’ have access to buy Wellness Core, try another grain-free food. Grains produce a lot of inflammation and are far too difficult for dogs or us or cats and a variety of other mammals to digest. So, the reason to get off of them is to help with the inflammation and to lose fat…too many starches in a grain-based food. Look up the Purina Body Score chart and aim for 4.5. If he’s carrying too much fat, first change the food and eliminate treats. He should lose the fat slowly. Don’t go by numbers on a weight scale…it’s never going to help nor is it going to be accurate for lifestyle, especially since injury almost always brings about muscle atrophy from disuse, and the usual medical weight scale doesn’t differentiate. Muscle weight vs fat weight makes a big difference…

Blessings-

Deborah

Debi says:

Deborah, Great suggestions. I’ve always been pretty strict with weight since I know that takes years off a dog’s life and I want my kids around as long as possible. This is why walking is so important. We had quite a workout going before he injured himself and I want to regain as much of that as I can. I do have to keep in mind that he is 9 years old.

I just checked out grain free foods at our local store. Thanks for a brand name. It gets pretty overwhelming and expensive especially when giving a couple of prescriptions and supplements. As far as treats. I will have to ween them off (I also have a 12 lb Chihuahua weenie dog) Otis is so difficult when it comes to meds. He figures out the trick within a day or two and I have to think of something new. That’s why antibiotics 3 times a day is not a fun prospect. We did that right after surgery along with the pain meds. By the end we were using a pill shooter straight down his throat. It took 2 of us to get it done. He was so over it by the end he actually growled at me once. Poor baby. At least the tramadol is small and I’m only giving him half ever 4 to 6 hours. I will try the canned food. No guarantee it will work.

We will see what a food change, slow rehab and pain meds do for getting him on his feet. I will do whatever I need to… I would never give him up to a shelter just because it got difficult or expensive. A dog is a life long commitment just like my human kid. Thank you for your time and suggestions.  Debi

 

Filed under: Q&A (Make Sure You Click Link to Older Posts Too) Tagged: CCL ACL surgery on both knees needs rehab, dog knee surgery both knees, dog not using leg well after knee surgery, dog painful after knee surgery, therapy for dog after knee surgery

Dylan, Terrier, Lame and Not Bearing Weight Many Weeks After Knee Surgery

3/11/12

Last week I evaluated another dog with persistent disuse & pain after CCL surgery ( for torn ACL / CCL).

Here is a copy of the synopsis I sent via email to the owner and to the vets. I had already made a phone call and left a message with one of the treating vets.

As promised, here is a bullet point email synopsis of our visit today. I am also sending a copy to Drs. Txxx, Exxx, and Wxxx since they have all been treating Dxxx. As I texted to you, I did contact Dr. Txxx after our visit, and I left a vm for her, trying to detail what I thought was going on with Dxxx. She and I subsequently texted a bit and she noted that she gave Dr. Exxx a heads-up since he is the one who did the surgery and since you may be contacting them tomorrow.

Dxxx is able to walk on sx limb and often chooses not to do so. He is 2-4/4 lame; 2 at a walk and 4 when faster. He is quite atrophied in L thigh, especially lateral. He is 7/9 PBS with substantial fat pads over both hips, adding to the deformed appearance of L hind. Fluid sac exists at L lateral stifle and you said the vets were aware of it and it was deemed a fluid collection related to suture. Mild to moderate effusion in L stifle, and I worked with owner so that she could feel it and become accustomed, able to tell in the future if/when it subsides. Dxxx has not consistently been receiving pain meds recently.

At this time out from surgery I would expect Dylan to be consistently using L hind and atrophy to be (mostly) resolved, no effusion.

1) Begin dosing analgesic this evening. You may use Metacam as previously directed and so long as his liver values are fine. You may use Tramadol as scripted on the bottle. We discussed the mechanisms of both drugs and the potential benefits/drawbacks. If his lameness is not resolved using these analgesics and/or possibly using the Gabapentin that you also mentioned he has been scripted, then you are to contact the vets no later than 2 days from the time of pain med dosing to discuss the possible use of antibiotics and let them know of the continued disuse on top of medication dosing. I have seen many cases like this that have persisted in lameness and had mild effusion (or no effusion) in which existed a low-grade, latent, painful infection. In these cases, depending on the antibiotic the vet chose to utilize, the lameness was mostly or fully resolved within two days, usually at the end of one day. Given Dylan’s dynamics (licking busybody), it is highly possible that this is what is occurring. The vets in other cases I’ve worked have chosen to dose the meds and not tap the stifle joint because the meds are relatively easy and the joint is then not disrupted nor the chance of new infection introduced. I touched on these ideas with Dr. Txxx, and I do not know what she passed on to Dr. Exxx, however they will discuss it further and will likely want to have a look at him if they have not seen him in a while. Please do not hesitate to call them sooner than in two days, and I’m sure they will be glad to talk with you or see you.

2) I recommended you follow this link: http://rehabilitationandconditioningforanimals.wordpress.com/category/homework-suggestions-for-functional-rehab/ to my “Homework for After Knee Surgery” and read it thoroughly. Begin working Dxxx at week 1 two days after most of the lameness has improved. Again, I expect the disuse to resolve with either pain meds or antibiotics or both, and in my experience it will resolve within two days of the medication that hits the problem.

3) Follow this link: http://rehabilitationandconditioningforanimals.wordpress.com/category/qa/ to Q&A about limping and knee pain after surgery.

4) Follow this link: http://rehabilitationandconditioningforanimals.wordpress.com/2011/07/30/water-treadmill-is-definitely-not-necessary-for-rehabilitation/ to more on joint pain, water treadmill, and rehab work.

5) Slowly reduce treats and a small amount of pm feeding. Measure the food he receives currently so that you are able to control the amount you reduce. Losing the extra fat will help with his function and protect his joints. Lots of research exists regarding this concept.

6) Begin giving ~200 mg EPA and ~100 DHA in fish oil daily. This amount may be doubled. You may use the brand you have or some from (the clinic).

7) Please keep me posted regarding his progress with the different meds. We will recheck in one week. In the future I intend to discuss massage. I believe acupuncture and laser therapy could help him, at least for the next 6-8 wks, as he resolves these issues. I expect him to be able to follow the homework protocol as written for the first 4 weeks after pain management and then we will discuss the program for weeks 5-8. After that, it is up to you, should he be improved and doing well, as to whether or not you would like further, more dynamic, homework.

Thanks again!

Blessings-

Deborah

AND, here is the owner’s follow-up report I received via email just a bit ago:

Hi Deborah, I was about to send you a quick text, when I saw this email (one I, Deborah, wrote asking how Dxxx was doing). Yes, Dxxx started antibiotics on Friday, and wow, what a difference. I saw almost immediately the change. Yesterday, almost all his walking was done with his leg down. I can really tell a difference. Thank you so much for getting us on the right path. I look forward to seeing you Tuesday.

He continued to improve and over about 3 months time he was equally muscular in both hind and had lost the extra fat he was carrying.

***

I have very many stories like this one, and I just now had time to share this one.

Hope it helps-

Filed under: Q&A (Make Sure You Click Link to Older Posts Too) Tagged: dog knee pain, infection pain in dog, knee pain from infection after surgery, terrier knee pain after surgery

Boomer, 2 yo Brussels Griffon Mix, Limping 7 Months After Surgery for Luxating Patellas

POSTED BY FELDMA23 | NOVEMBER 18, 2013, 8:22 PM

Hi there, I have a 2 year old Brussels griffon mix that has had 2 surgeries to repair his luxating patellas last April. We’ve been to the vet for all the check ups etc but Boomer is still limping. I give him joint vitamins and a balanced diet. I also try to not over exercise him, which is difficult considering he’s still a pup (I mean, aren’t they always puppies?). Anyway, his right knee was the major culprit. Vet took xrays about 3 weeks ago and said there is inflammation but no real cause. He said the pin could be causing irritation. I am inclined to think otherwise because his left leg is starting to give as well. He was put on rimadyl for about 3-4 weeks and it helped a bit. Anyway, Boomer is in training (almost ready for certification) to become a service dog and he is doing so great but it would be so helpful for him and me if he was in less pain. Do you have any suggestions i.e. homeopathic remedies? Please keep in mind he loves to play, which I think has been a large contributor. Thank you so much, looking forward to your response. -A

POSTED BY REHABDEB | NOVEMBER 19, 2013, 8:40 AM

Hi!

A couple of quick thoughts I have, based solely (of course) on what you’ve said and keeping in mind I haven’t seen your “always pup”

I see a lot of cases that are months or even years out of surgery and are still favoring their leg (s) and sometimes limping as if they had surgery just a week or so ago.

You didn’t say whether or not you read my posts on pain on this site, so I recommend you do that and I believe you will find some answers.

Let me know if you have further questions after you read the pain posts and my homework paper on luxating patellas.

Blessings-

Deborah

 

Filed under: Q&A (Make Sure You Click Link to Older Posts Too) Tagged: brussels limping after surgery for luxating patellas, dog limping after knee surgery, dog luxating patella, luxating patella surgery

Failed FHO on 8 Month Old Rescue Lab Mix

POSTED BY KRISTI MARNELL | JANUARY 25, 2014, 11:00 PM

Hello, I have a question re: a failed FHO left leg for our 8 mo old rescue dog white lab mix. Our daughter got him post op when he was about 5 mos old. There were no instructions on rehabbing him. He continuously favored his left leg, and was on Rimadyl when my daughter brought him home from school in Dec. we tried 1 visit of accupuncture. We found out that he has a very low pain tolerance, but it seemed to help for about 4-5 days along with the Tramadol. He is now on a course of Tramadol every 6-12 hrs and Deramaxx 100 mg 1/2 tab every 24 hrs for the last 2 weeks. He weighs about 48 pounds. I work full time and can only walk him about twice per day. When he feels well he plays and torques and twists; he then is in such pain that he can only sit up at night and it is hard for him to lay down. Needless to say I am not getting much sleep at night. I am not equipped to continue rehab on him; I don’t have a pool and there is no animal rehab in my area. My question is, what can I do to help him? The vet says that another Surgery will not help him, he doesn’t have any real muscle mass to help him. At this young age I can’t see him on a long course of meds. I think the vet ruled out infection but not sure and I will follow up with that. Is removing his leg a viable option at his age? We are basically fostering this dog since our daughter is in college and none of us can really afford continuous treatment or surgery at this point in our life. We would like to get him to a point where he is somewhat pain free and find a good home for him.

Thank you for your time and expertise.

Kristi

POSTED BY REHABDEB | JANUARY 27, 2014, 11:12 AM

Hi there!

I have some steps for you to follow *exactly* and then get back to me if you’d like

You say it’s a “failed FHO”, and I see very many of those, able to rehab them to full function or thereabouts, so take heart! I’m glad you wrote

1) I am writing (soon) the full FHO post-sx booklet, but in the meantime, you will be well-served to buy the paper copy (so you may make written notes) of my post-sx rehab booklet for knee surgery for torn ligament, here: http://www.amazon.com/dp/B00EY3D03S and follow it as if your kiddo just had surgery. I promise this will help and this is the place to start. I suggest reading the booklet twice, especially the parts about pain, because that is your biggest obstacle right now.

2) Begin doing the work in the booklet AFTER getting at least two analgesics back into your dog. In my experience with cases like this, you will need 2-3 pharmaceutical analgesics to help, and for research-based reasons I don’t have time to go into (see my research posts on nsaids), I’d prefer not using an anti-inflammatory right now. We need him to use the leg and build muscle= Tramadol & Gabapentin (usually used in my area), along with adding the supplements I discuss in the book and along with

3) Start the massage as I demonstrate in my video under the “Videos” section of this site.

Ok-that’s a little bit from my perspective, but it may be a lot for you, especially since you may think you’ve exhausted resources (but you DID reach out to me :)) The most important thing is everything I mentioned…and especially paying good attention to the chapters on pain in my booklet. You definitely do not need a water treadmill, water work, or a rehab clinic at this point; your pup needs very good pain control and controlled activity, restrictions and controlled drills.

I have never had an animal fail to respond well to my protocol for after FHO surgery or even after work to improve hip muscles after diagnosis of “really bad hips” or “dysplasia”, so please give it a go! I cannot emphasise enough how much people undervalue and misunderstand the role of pain medication after surgery…if you can overcome the obstacles of not enough pain meds and too much activity, you’ll be on your way.

Blessings-

POSTED BY KRISTI WETZEL MARNELL | JANUARY 28, 2014, 12:43 PM

Thank you Deborah! I will get started on this today. We have an appointment with the orthopedic surgeon this Thursday so I will ask about the analgesics. Again, thank you for your suggestions.

Have a great day,

Kristi

POSTED BY REHABDEB | JANUARY 28, 2014, 1:11 PM

You’re welcome!

 

Filed under: Q&A (Make Sure You Click Link to Older Posts Too) Tagged: dog hip surgery botched, dog limping after hip surgery, dog rehab after hip surgery, failed fho dog, failed fho puppy

Dog Torn Ligament Surgery 3 wks Ago, Still Not Putting Much Weight on Leg

POSTED BY ABEL | JANUARY 5, 2014, 12:14 PM

Hello Deborah -

Thank you for publishing your post ligament surgery guide. It has been an invaluable resource. Our dog had the lateral suture procedure about 3 weeks ago. She seems to walk reasonably well on her bad leg but still doesn’t put much weigh on it when standing. My question is regard to continued exercise after week 4. What are you general recommendations with regard to walking times and pace?

Thank you again for your great post surgical guide.

Regards,

- Abel

POSTED BY REHABDEB | JANUARY 8, 2014, 8:06 AM

Hi! Thank you so much for the kind words, and I’m so glad the guide and you and your dog are doing what I hope in using the guide I haven’t yet published weeks 5-12 because I’m working out how to approach the nuances of outcomes from people following the first four weeks. Even when I meet with someone here in person, in Austin, and then go back to evaluate compliance and capability, etc…a week later, I find that often there is a wide variety of interpretation and action. That’s to be understood, since we all see the world from a different perspective…

Sometimes I see animals at 5 weeks, and they have been doing 4 weeks of exercises from my book or my online posts, yet I find they are not ready to move past week 1.

I could speak more to this situation, but I also have limited time this morning…I will email you to set up a phone consult with video review, if you’d like to do that. There is a small charge (relatively), but I’ve found it’s necessary in order to block off appropriate time in my schedule and treat you and your pet well in giving recommendations.

Thanks for contacting me, and Happy New Year!

Blessings-

Deborah

POSTED BY REHABDEB | JANUARY 18, 2014, 1:33 PM

How is she doing at this point, Abel?

Sounded like she was in need of more pain medication, and that may ring true with you as you review the pain sections of my booklet. If she is not using the leg while hanging out in the house, even if she has been making herself use it on the slow walks, then the culprit is usually, overwhelmingly, not enough pain meds. Realistically, most post-surgical pets (and people) need pain intervention for 6-12 weeks post-injury or post-sx, yet most are given only a week or two of such. Then they have to grin and bear it or they get referred to a water treadmill when additional pain meds of the correct variety will solve the issue. Keep in mind the potential for infection, which would cause pain yet require antibiotics to reduce that pain=regular pain meds won’t usually correct the pain of infection. Also, most dogs do best on a combo of at least 2 pain meds in moderate amounts, at least. One med usually isn’t enough, and depending on the drug, a small amount dosed once or twice daily is usually not enough. That statement is based on the most common drugs used in my area in the U.S. Other areas of the world have different options (or no options ;P)

All for now-

 

Filed under: Q&A (Make Sure You Click Link to Older Posts Too) Tagged: dog knee surgery not putting much weight on leg, dog lateral suture surgery for torn acl ccl, dog walking after knee surgery

Junior, 9 1/2 yo, Atrophy and Lameness After Surgery for Torn CCL/ACL and Meniscus

POSTED BY DAYNA PESENTI | NOVEMBER 20, 2013, 3:15 PM

My dog had surgery for a torn ACL and a torn meniscus about 10 weeks ago. He is 9.5 years old and making a slower recovery than the vet would expect. He is using the leg but not building much muscle back. I could use some advice on how to proceed with his rehab and I would love to set up a phone consult if possible as I am in California.

Thanks!

POSTED BY REHABDEB | NOVEMBER 21, 2013, 10:49 AM

Hi!

Thanks for writing-

If you were here in person, I’d start by telling you the same thing as I’m writing here now:

Follow the link to get a copy of my post-surgical book for 4 weeks of rehab after this surgery.

In the book I explain at length why it doesn’t matter if the surgery was a day, a week, a month, or a year ago, and I outline how to determine where your dog falls in the recovery process.

Read it all the way through (it’s short and inexpensive), and then begin.

Honestly, I see hundreds of cases like this, and every one of them needs to start at week 1 or at week 2 at the most.

I also explain why your pet isn’t seeming to build muscle, even though it looks to you like they are using the leg

Once you get the book and follow everything in it to at least 90% compliance, write another note, and we’ll pick up from there!

The book also recommends watching my massage video, also on this site, twice, and then beginning doing that daily.

I have every reason to believe you will begin to see more success if you take a deep breath and get the foundation base established as I outline. After that, you guys can move on to harder work.

Thanks!

Blessings-

Deborah

Guidelines for Home Rehabilitation of Your Dog: After Surgery for Torn Knee Ligament: The First Four Weeks, Basic Edition

http://wp.me/P1wSDA-bt

POSTED BY DAYNA | NOVEMBER 21, 2013, 11:24 AM

Thank you! I wasn’t sure the book would apply so far out but I will order it now and read it from cover to cover.

POSTED BY REHABDEB | NOVEMBER 21, 2013, 11:29 AM

Great, and I’ll look forward to hearing back from you.

I’m working on the paperback, so this one is only on Kindle for now, but you may see it from your Mac/phone/PC using the app. You don’t need to have a Kindle. (paperback is now available 2/14)

What’s your dog’s name?

POSTED BY DAYNA | NOVEMBER 21, 2013, 11:33 AM

I already bought it and I am having no trouble viewing on my PC. My dog’s name is Junior

POSTED BY REHABDEB | NOVEMBER 21, 2013, 12:12 PM

Awesome!!

Carpe diem, Junior-

POSTED BY DAYNA | NOVEMBER 21, 2013, 1:39 PM

I read the book from cover to cover and I am going to start his walks using your method. I have been walking him 25- 30 mins once a day but I think the pace was too quick. I will start walking him 3-4 times a day for 10 slow minutes and see how that goes. I also think he should probably still be on pain meds from what you are saying. He uses his leg but he is “lighter” on that leg than his other one, making me think he probably has some pain. I will talk to the vet about that and I still have Rimadyl and Tramdadol from his surgery.

I have a few questions. First you say no water treadmill’s which is fine because we don’t have one to use, but what about my human treadmill at home? It has been quite rainy here and Junior HATES the rain. To get his daily walks in would it be ok to have him walk on my treadmill at a slow pace? He is already used to walking on it and does fine.

Even though he is walking and using his leg, do you think he isn’t building muscle because he is walking too fast and is still somewhat painful in that leg?

POSTED BY REHABDEB | NOVEMBER 21, 2013, 8:24 PM

Good, on acknowledging the 10 min, slow pace for him for now…

I agree about the “lighter” part, and once you get going on the specific walks, slowly, you will possibly see more limping…and you already know I cover all that in the book, so I won’t repeat.

You could use a land treadmill, but sometimes that causes additional problems; I usually don’t recommend it unless the dog is already accustomed to working on one, like some of my competition client dogs are. There are specific cautions I use to introduce them to the treadmill, and I’d hate to see him freak and scramble around on you and hurt himself worse! That being said for anyone who reads this, since he’s accustomed to it, yes, you could probably have success with walking him on the land treadmill on rainy days. I don’t recommend it for all his walks, because it does dictate gait differently than if he weren’t on it. It’s a good option in the situation you described. Make sure you have him go very, very slowly. For others in this predicament, if possible, for the shorter walks (10 min), can you turn on some music and make a non-stop path around the house? That works with a lot of my clients, even in a small home.

And, yes

Blessings-

Deborah

Filed under: Q&A (Make Sure You Click Link to Older Posts Too) Tagged: dog lameness after surgery, dog muscle atrophy after surgery, surgery for torn acl dog, surgery torn meniscus dog

Marco, 2 yo Pit Mix Hit by Car (HBC), Leg Broken

My 2 year old pit mix had been hit and broke his back leg. We had surgery and he was with pin for 8 weeks. Some bone fragments had to be removed but now after removal of pin his leg is healed. But is shorter and the muscle have shrunk. I do leg exercises but he will not and has not used the leg since the surgery. I’m very concerned and the vet assures me he is healed and it will take time. Is there anything I can do? To help Marco use his leg again? Thank you.

POSTED BY AUDREY BLANKENSOPP | JANUARY 13, 2014, 11:15 AM

Hi there

First, do you happen to be in my area? I couldn’t tell from the info WP gives me if you are or not…usually it gives me an area. If you are, then we should definitely schedule an appointment. If you aren’t, (and even if you are), my best basic advice is for you to get the booklet I wrote for after knee surgery, and treat your Marco the very same way for the four-week protocol the book outlines. Realistically, this type of injury should have about 12 weeks of progressive and productive rehab…some animals take more time for their actions to be productive.

Pay particular attention to the chapters on limping and pain. The surgery may have gone well, and the bone may be technically healed, but a break is continually painful, and almost every case I see needs to be on more pain meds and on them longer.

Get the booklet, here: http://www.amazon.com/dp/B00EY3D03S

And work with your veterinarian to get 2-3 analgesics on board. I can almost guarantee, based on hundreds of cases I’ve seen, that if Marco is less painful, he will begin using the leg. The longer you/he waits, the more contracture and the more scar tissue of the wrong type will occur.

Let me know if/how you follow through, if you want-

Blessings-

Deborah

Filed under: Q&A (Make Sure You Click Link to Older Posts Too) Tagged: broken leg dog rehab, dog hit by car, dog limping after surgery for broken leg, hbc

Oso, 9 yo Lab Mix with CCL Tear, Possibly Both Knees-

Hi Deborah,

First, thank you so much for creating this site – it is so helpful and full of great information — I only wish I lived near you to have the benefit of a visit, but this will do for now! I have ordered your book (treating without surgery) and am eagerly awaiting its arrival so I can read it and implement your plan. In the meantime, I have two questions about Metacam and also depression.

My 9 year old Lab mix, Oso, has been diagnosed on 1/21/14 with a CCL tear on the left stifle (the worst side) and potentially one on the right as well. I do not plan on surgery for the injury as I would prefer to use holistic methods to help him heal. I would like to know your thoughts on Metacam. Since the evening we went to the vet for xRays, Oso has been on 2 50mg Tramadol 2x day and one dose, by weight, of Metacam which I give him after his dinner. He also is taking the high dose of Dasuquin with MSM for large dogs, as well as several Standard Process compounds. My goal is to eliminate pain and swelling as much as I can without putting him in a daze. He is 88 pounds. I keep reading bad things about Metacam side affects…but don’t want to remove it since it is an anti-inflammatory. Our vet agrees and has not set any end-dates to this regimen. I would love your thoughts on the long term use of this drug — and potential alternates that I can discuss with the vet.

Also, what to do about doggie depression? Oso loves to chase birds and squirrels and he has been completely restricted from running by using a temporary fence in the backyard. The last several days I see what I would call depression behavior. Any thoughts on how to avoid that without allowing him to run and play?

Oh and if you prefer to answer these questions via phone, just email me with your rates and possible schedule — I am in Seattle so we have a bit of a time difference.

Thank you again for an awesome resource site!

Marla B

(Deborah’s note: we moved to email to discuss phone consult possibilities)

I realize I didn’t answer one question in the emails we exchanged, and that was about depression.

Yes, I do find that there is what seems to be an element of depression accompanying injury in our companion animals. It’s actually frequently a big issue in human athletes. Two factors effect this status:

Pets read off of the caretaker’s mood, so I spend a bit of time explaining that to clients and encouraging them to not feel and project anything about “poor puppy” to their dog while they are in recovery process. This really does make a difference, and I don’t have more time to give examples right now

Just continually encourage them that they are ok and that you are ok with them the way they are. REally.

The second factor is the way I have designed the workout regimen. The regimen is compliant with the best recovery information available as well as attentive to species differences between humans and companion animals. The sessions are multiple at first, yet short, and they allow for bonding and giving importance to the pet while being productive. I find that caretakers and pets welcome the structure as well as feel like they are doing something beneficial several times a day, and that makes a lot of physical and attitude difference!

Blessings- Deborah

Hi Deborah, 

I read most of the book today and if it was not absolutely pouring rain, we would be going out for a 5 minute walk tonight! 

(Rehabdeb: Keep in mind that most pets and homes will accommodate an indoor 5 and 10 min slow walk for purposes of rehab. I recommend using the harness and making it “official” so they get the idea. Obviously no stopping and sniffing or peeing indoors during these walks, either  )

Are you writing a “long version”?  You mention that several times in this edition.  

(Rehabdeb: No, there aren’t additional weeks written yet, mostly because I’m swamped, because I have several more intro injury booklets to get out first, and because there are some variables I haven’t quite figured out how to overcome and I probably won’t be able to overcome…but I’m working on it. Those variables include people taking animals off of pain meds far too soon, the pet being lame and painful, yet the people press on with the hills or stairs or complicated routines, because they just don’t know and understand the injury and process. I see clients locally after they have read the booklet, and they are “on week 4″, but they haven’t followed most of the instructions, so they really should be fastidiously making sure week 1 is accomplished in all of it’s simplicity. Simply, if the pet isn’t using the leg, and all the caveats to that I cover in the book, it’s not time to progress to week 2 It’s kinda a mystery to me, but I get it, because I didn’t get to know as much as I do without cutting corners and suffering consequences ;) So, I’m still doing remote consults using video viewing and phone for now.)

I feel very good about the process you have outlined and I actually have seen how a bit of exercise (as in 5 minutes) made Oso feel better, mentally and physically. 

That’s great news!

We had snow on Sunday, his favorite thing and he was so bummed already (the depression I mentioned) so I put on his harness and we went out in the snow.  He actually put down his leg for the first time since Jan 20th and tried to use it.  We did that twice and what a wonder – he has been trying more and more to use the leg, or at a minimum, toe touch when eating or drinking water.  And not nearly as bummed out.  So I know your plan will work as we tried it without even knowing the plan (before I read the book).

Great! 

So long story long,  I would like to do the plan as the book describes it and see if that brings up questions as I am guessing it will.  Do you do any morning sessions (since I get up early for work anyway and we have the time difference to work with)?  That way I could take a couple of weeks and let you know when I need a pow-wow and we could schedule a morning.  Or worst comes to worst, sheesh, I can come home early for once!

Yes, we may schedule a morning phone consult  

And yes, if I could help clone you so you could come here, believe me, I would.  I am in no man’s land for holistic pet care.  North of me and east of me, there are more practitioners but around my area, nada!  Our vet is great though – he does acupuncture and Lomi Lomi – Oso has had both.  

Thank you!

Marla B

Keep up the good work!

Tagged: dog torn acl both knees, dog torn acl ccl no surgery, dog torn ccl both sides