Cage’s Rehab: Strength

With Cage now somewhat comfortable and showing improvement with rehab, we could really start things moving. In doing that, I had to anticipate that Cage WOULD get better. That meant putting some things in place so that WHEN he was walking his body would be at its best.

The first thing I added to his regiment was a Chinese herbal compound called Double PII. This is a blend of herbs that promotes spinal cord healing and therefore better “messaging” from his thoughts to his actions. Herbal compounds can take 2-6 weeks to see improvement, so we started those once he was comfortable.

Two weeks into his rehab, Cage didn’t have sore muscles but his elbows were very uncomfortable. Remember that he had severe arthritis in both elbows for a few years now. And with 4 weeks of him putting most of his weight on his front legs, the elbows were causing him a lot of discomfort. We focused therapy with TENS and therapy laser to the elbows for short-term relief.

I also started him on Adequan injections. This is a substance that has anti-inflammatory properties and also helps prevent the cartilage from wearing down. With intact cartilage, we avoid bone on bone contact which is extremely painful. The injections can have both short and long term positive effects on the joints. They are injected into the muscle so they help ALL of his joints (remember he had knee surgery and has arthritis there as well).

With these two mechanisms in place, we had a steady routine with Cage. Each day he got acupuncture, heat, massage, range of motion exercises, electrical stimulation and therapy laser treatments.

Each day we helped him to stand so that he could relieve himself (sometimes we had to stimulate him but he progressively was able to go on his own if we were patient with him). Each day he was with us he got to float in the underwater treadmill. Here the buoyancy of the water allowed him to feel like he weighed 45 pounds instead of 70.

Some days he showed progress. Some days he didn’t. What was important was that he didn’t show any regression. Neurological rehab takes time. Nerves heal at about a MILLIMETER per DAY. That means an inch of nerve can take up to 254 days to heal, that’s over 8 months. This is why it is important to be patient with these patients.

While we were doing things to promote better nerve conduction (acupuncture, TENS) and increased sensory input (having him standing, using his legs, letting him urinate on his own), we also worked on him having muscle to be there once the message came from the nerve. So, each day, he got electrical stim pads applied to his hind legs and spinal muscle groups. The goal here was to minimize the atrophy that was occurring. Electrical stim won’t replace the body’s natural muscle tone or strength but it can be used to contract muscle and can minimize atrophy. If we don’t do these things, then even if the message gets from his brain to his legs to move there isn’t any muscle to do the actual work.

Even with keeping up with food and trying to minimize atrophy, Cage dropped another 6 pounds in the first 4 weeks he was with us.

Initially, any physical activity was exhausting for Cage. Even with our support and the buoyancy of the water, he still had to move against gravity. With each week, he made noticeable progress. Some weeks were tougher than others because sometimes he was mentally checked out. We built in rest days for him to recover. Mostly these were at home with family. Occasionally, we asked him to do less physically when in our facility because of the time spent being active with his family.

For the first few weeks in the underwater treadmill, I would be in there with him moving his legs for him. As he got stronger, I would be in there just to act as a bumper and keep him from sliding back on the treadmill. He eventually got wise to this and stopped putting in effort. Then, I took myself out of the treadmill and we worked with him on a harness to keep him walking. Our results were mixed some days. He was not a food motivated or praise motivated dog. In talking with his family, they mentioned one particular toy he was fond of. I asked them to bring that to his next session. It was a tennis ball “dumbbell” with a built in squeaker. Here is a picture.

dumbbell

 

This really changed everything. Now comfortable and moving, Cage WANTED that toy. We could use this to motivate him to play tug-of-war or to get him to fetch it in the treadmill. This proverbial “carrot on a stick” is what clicked for him. Sometimes it’s really the simple things that make us happiest.

When Cage first arrived, he could barely walk and needed a break in the underwater treadmill after 5 minutes. A month into rehab and he could walk for 30 minutes at a time. The water’s buoyancy helped him greatly. On dry land, he was limited but walking. What we saw was progress, motivation and strength.

cage23

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