Neurological and Paralysis Issues – 8 Posts
I built this for Tiny while I was doing rehab for her broken back. She has a standard cart, but a cart is a poor choice for Tiny and for her situation. This video is one of her first times in the Mover.
Tiny Improves in Mobility Mover
After working on a few drills a day in her Mover, Tiny ambles down her hallway during week 2 of Mover Mobility 
Drills I prescribed were specific to her neuro capabilities as demonstrated by action and not solely reliant upon diagnostic statements with the exception that I am always attentive to pain signs and diagnostics as relates to damage or injury that I consider when creating exercise protocol.
Tiny Walks – Broken Back Kitty
This is Tiny Kyle, the kitty with the broken back that I featured a couple of weeks ago in the mobility station I built specific to her needs. This is the most movement she has achieved since the accident over a year ago, and this is substantial, to say the least! We are all pretty excited
Great Dane with History of Canine Meningitis and Knee Surgery
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!
Homework Exercise Review for Elderly Sheepdog with Hind-End Neurological Problems
Here is the short write-up of my recommendations/reminders for Abby’s functional rehab and the process I believe will improve her neuro-muscular capabilities and strength.
Some of this will be stuff I’ve mentioned several times over the course of working with Abby, however it bears review, and most of the time, when I reevaluate a program, often we need to go back closer to a beginning point and press forward methodically in order to achieve expected gains.
I can’t emphasise enough how beneficial the vibrational massage is, even if you do it every other day instead of every day for now. For a refresher, please watch the 10 minute video here:
http://rehabilitationandconditioningforanimals.wordpress.com/category/videos/
And do it as best possible without cutting corners. Pertinent questions are also covered in the video, as well as methodology and benefits. Make sure you change out the batteries as soon as they seem dull, because the best benefit from this massage is realised from the vibration, which stimulates circulation, lessens tension, and potentially improves nerve conduction. I recommend, for now, doing the massage at the end of the day, at bedtime or thereabouts.
For the next week, please walk Abby twice daily, super slowly and consistently, without stopping, for 15 minutes. There are very many reasons why I use this method, and they all contribute to the gains we are trying to achieve. Super slow walking encourages use of all limbs to the best of their ability. Abby has already been able to walk multiple times daily, super slowly, for five and ten minute sessions, having built up slowly. Using the same exercise protocol for a week allows more time for the body to adjust to the work load, and it should go well, because these are introductory workouts, to build a base.
For the following week, please walk her 2×20 minutes in the same manner, if the 15 minute walks are completed well. She should be able to complete these walks without dragging a hind limb and without sagging or falling down. Otherwise, she needs to return to 10 minute walks and do them multiple times daily to ensure success. I am not after complete fatigue and maxing ability at this point; I am after building successful progress, which I believe her body will adapt and accomplish.
I really would like her to wear two supportive hard braces during these walks, and I realise you have only one. She hyper-extends her tarsal joints, and in order to use her hind legs properly and to subsequently use the muscles better/properly, the supportive brace that prevents hyper-extension while she is doing her slow drills would be additionally beneficial. (Orthovet Splint) Use the one you have on her R hind, since that leg has the most deficits and is the weakest. She hyper-extends because of nerve weakness and defecits.
After the week of 2×20 min slow, relatively flat walks, please add in cavalettis, obstacles, to improve her proprioception. This may be accomplished in many ways and several locations around your environment. I have photos on my rehab FB site that depict a trained sporting dog doing cavalettis using an extension ladder. I have a video on this site of a cat with neuro problems using a lineup of remote controls across a bar top. I have a pic on my FB site of another older dog using obstacles in the back yard. When time allows, I will attach some of those pictures to this post.
Abby needs to do the cavalettis every other day and during one of the walk workout times. You should warm her up walking for 5 minutes then do obstacle repeats for 10-15 minutes. I suggest you use about 5 items in a row, spaced about half an Abby-length apart, and between 4-6 inches high for now. If we could get the old cat to do the work, I’m pretty sure we can get Abby to do it! If she is too stubborn for you, I will be glad to take a rehab session and work with you and her on this drill.
After a week of this drill, keep doing it as prescribed, and add in hill repeats every third day as one of her twice-daily workouts. I suggest walking out the front door, around to the back yard, and then up and down the hill on the far side of the house for 10-15 minutes, very slowly. I was able to get her to do this work this past summer when I came for rehab checks.
During the hill phase, it may be more beneficial for Abby to receive laser therapy on the hill work days. This should have the effect of stimulating nerves and cellular process and often improves work ability in the older and neuro-challenged animals. In her condition, I see reason to have twice-weekly laser sessions for at least a month.
I think it would be great if you were able to just start where I suggest, as if we were beginning from scratch, and let’s see the progress that comes from scripted protocol and collaborative effort. She won’t improve from this point if she keeps doing the same walks and leads the same life she has been leading…the body stagnates, and the same happens for humans as well. Our brains aim toward conservation while our bodies are able to do more. I believe, based on my experience that is also based on years of research, that we will see strength and muscle gains if you start here again. I suggest we review in one month after these exercises have been completed. I will then revise the protocol and change the challenges.
Thanks!
Blessings-
Deborah
Water Treadmill is Not Necessary for Rehabilitation
Compared to the number of dogs in the world, then compared to the number of ruptured cruciate ligaments on aforementioned dogs, then compared to the number of said dogs with ruptured ligaments who are treated by a veterinarian, then compared to the number of those dogs who are taken to surgery for structural remedy, there are relatively very few rehab clinics in the world and fewer still water treadmills.
Dogs of the world do relatively “ok” on all areas of the treatment spectrum and definitely do not need to be “put down” due to ruptured cruciate ligament (torn ACL, CCL). I have encountered clients in my practice who were told unless they had surgery, the dog would have to go. Just wanted to clear up that situation.
That being said, and along with explaining the title of this blog, of foremost importance I will note that I came into veterinary functional rehabilitation with approximately 25 years experience in human sport science and nutrition. I decided to call my practice “functional rehab”, not having seen that designation applied much but having presumably heard the term somewhere. I decided to use it when I began an independent, mobile rehab practice in 2007, two years after starting and running a rehab clinic for a veterinary specialty hospital.
I became aware of the water treadmill via my work at the hospital, and I found that the use of it was/is widely promoted within veterinary medicine and the canine rehab model, which draws heavily from structured, academic-oriented, human physical therapy concepts. I think the overall concept is decent, yet the wtm is one very, very small tool in the vast array of protocol and modalities that exist in order to better the health of your pet.
Unfortunately, I found that what is not taught within this same model is a good basis and understanding of program design, writing training programs, and the development of dynamic activities/protocol designed to encourage healing and increase muscle and bone mass. These are principles I began learning over 30 years ago as an athlete, as a self-coached athlete, and then as a coach and trainer to others, even world-class athletes.
What does this mean to you and your pet (primarily dogs…)?
The chief complaint I hear from people who contact me is that they were referred to this clinic or that one for post-surgical rehab, and after many weeks of walking in the treadmill, moving around on balls, and doing a variety of other things, the dog is not much better or is not to a place where the owner feels comfortable with letting them be loose and rambunctious. They aren’t where the owner thought they would be after surgery. When I was in a clinic setting and working on utilising the wtm we had, I did structure the workouts to be progressively difficult, using a 3x workout adjustment protocol, meaning that if three workouts went well, then I changed the protocol, making the workout more dynamic. This could be done by increasing time or lowering water in the tank. Since I do not believe that much benefit is realised by walking in a wtm more than 20 min., and some data is published to recommend that animals not be worked beyond that time anyway, I find more benefit realised by lowering the water height, thus increasing the force on the joint/leg/muscle/bone.
HOWEVER, I also find that after very many years of reading many, many reports in sport science and regarding functional return to activity, the best benefit is realised via gravity-based, slow, structured exercise protocol, and I began developing that for small animal rehab since I did not find any published when I arrived on the scene.
Your dog will use their leg to some extent and increasingly after surgery if he/she is not in pain. That has been my finding after working with hundreds of cases. With that in mind, a structured workout program is entirely necessary and may vary from any standardized protocol depending on the nature of the dog and the owner.
If your dog is not using the leg within 2-3 days after surgery, then my findings are always that they are in pain, and that they are in pain due to 1) not enough post-op analgesic, which I believe should be a combo of at least two analgesics for potentially several weeks while we pursue the best activity and homework for healing (in this area we commonly use an nsaid and Tramadol); 2) infection, the pain of which will only be finally remedied by antibiotics (and subsequently the infection remedied as well); or 3) structural abnormality, i.e. some sort of failure related to the surgery, yet not necessarily the surgeons/your/your dogs *fault*.
The homework protocol I generically recommend is contained elsewhere in this blog. If you are within range of my services, I recommend you contact me for an evaluation appointment and we establish a base for your dog and then you perform the exercises which will bring solid healing while helping to also protect the opposing limb.
Thank you!
Great Pyrenees Knee Surgery, Hip Surgery
Hi Deborah,
Gus Maxwell Porch Swing Sling
Teri also commented on Rehabilitation and Conditioning for Animals’s link on Facebook
Teri wrote: “Hi Deborah Carroll…although you did a superb job working with our Great Pyrenees Gus post-surgery…I would also HIGHLY recommend to anyone considering surgery (especially on a large dog) to go to all lengths trying non-surgical resolutions. As you know, Gus had the knee surgery and had every possible complication including blowing out the opposite side hip joint. Although he doesn’t consider himself disabled….I wish I had done things differently when he first had symptoms. As always….you’re the best!
My note:
The above picture is from my (Deborah’s) files…Gus enjoying the day in his porch sling I made, using pulleys and my favorite cheap harnesses (Travelin’ Dog from Petsmart online-use in rear and sometimes front). Owner Mom could help him outside during the day and then get him upright using the pulleys without as much stress to her body. I think Gus weighs more than she does!
Kacey Cat Does Cavaletti Work
http://youtu.be/IqwFemytxzs (CLICK HERE)
Kacey has neurological problems in her hind end. I have been performing laser therapy on her and working on finding exercises that will benefit her quality of life. The owner and I discovered during one visit that she would walk one direction across a particular section of bar top to get to some place her kitty brain holds special…so special that she will repeat this action many times.
I placed 5-6 remotes across the bar top, and Kacey is to make 5-6 passes over all of them, every other day, doing it all at one time.
She has improved much around the home, and we made some other exercises work for her too.
She is working on losing some of her “extra”.
Click on the link above to view the video.
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