How do I ??

I will be posting information on fundamental parts of veterinary rehabilitation that you can do at home with your pet. Always do these under the instruction of your veterinarian.

http://www.cliniciansbrief.com/article/how-passive-range-motion-exerciseshttp://www.cliniciansbrief.com/article/how-passive-range-motion-exercises

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It’s who you know

Dog: Cage

Signalment: Ten-year old neutered male Rhodesian Ridgeback cross. 80 pounds.

History: Owner received as rescue a number of years ago. He travels with dad from upstate NY to Boston weekly for business. He is very much a “daddy’s boy.”

Prior medical history: Cage had cruciate (ACL) tears in both knees (individually) a few years ago. Both were surgically repaired. He also has elbow arthritis bilaterally (both front legs) that is managed with Metacam and Amantadine.

Earlier in 2015, Cage had chronic back pain and trouble using his back legs. He had an MRI that showed a bulging disc in the middle of his back and a large mass on his spleen. He was conservatively managed for his bulging disc and repeated ultrasound examinations were done of his spleen. Ultimately his spleen was removed and the mass was found to be benign.

In early June, his back pain continued to get worse and he had surgery to remove the bulging disc and take the pressure off his spinal cord. Surgery went well and he was moving better almost immediately.

Two weeks after surgery, he developed a fever and lost function in his hind legs. A follow up MRI showed inflammation at the surgical site and a second surgery was done. The area was lavaged (cleaned) and some of the surgical material that is normally left during spinal cord surgery was removed.

Cage was then hospitalized for a week to manage him as a paralyzed dog. He had minimal function in his back legs and needed to be catheterized since he couldn’t urinate on his own. He was placed on antibiotics for the surgical site infection based on a culture sample that was taken at the time of surgery.

Since his family spends most of the summer on Lake George, Cage was moved there in late June. As chance would have it, Cage’s neighbors and friends were Dixie and her family.

Dixie is the dog that had been shot in the neck years ago and had been under my care to learn how to walk again. I still see her on a regular basis to help maintain her mobility and comfort. (For more about Dixie click here https://drbrunke.wordpress.com/2014/02/28/dixie-the-miracle-dog/).

On a recommendation from Dixie’s family, Cage’s folks reached out to me. We talked about his condition and some of the different therapies used to treat paralyzed dogs. I met Cage the next day along with his mom and dad. After a physical exam, we had a long discussion about options for Cage.

A neurological recovery can take weeks to months. It can take a physical and emotional toll on both the patient and their family. I could not give his family any guarantees that Cage would walk again. Complicating Cage’s condition were things beyond his or my control. His dad had to work in Boston 4 days a week, their house in Lake George is an hour away from the hospital and he weighed 72 pounds. (He had lost 10% of his body weight in muscle loss from being paralyzed)

Cage’s size and weight are added complications to recovery. When a 15 pound dog is paralyzed, it can be picked up and moved about as needed. To move Cage from his bed in the living room outside to urinate took 2 people and almost 10 minutes. Bigger dogs also make bigger messes if they have accidents in their bed and it can be challenging to keep them clean.

Trying to coordinate a schedule that would be beneficial to Cage and also work for his family took a bit of creativity. Ultimately, his dad would drop him off Monday morning on his way to Boston, he would get rehab and acupuncture Monday and Tuesday (staying overnight here) and then his “uncle” would pick him up Tuesday night and take him home. Wednesday his mom and Dixie’s family would manage him and then Thursday his mom would drop him off with me. Thursday and Friday would be more rehab and acupuncture and then his dad would pick him up Friday evening.

I told his parents he had about a 25% chance of walking again. This was tough but I could not give them a lot of hope. Paralyzed patients can make improvement and then plateau at a certain point. Sometimes it can take 3-6 months to make a complete recovery. I would update them daily but would look for significant steps each week. They committed to our treatment plan for the month of July and then would reassess.

I will post more about Cage soon. For now here is a picture of him soon after starting rehab.

Cage in the overhead hoist

Cage in the overhead hoist