Tuesday, June 22, 2010

Introducing Phoebe, the cocker spaniel - partial cruciate tear

I saw an adorable 3 year-old cocker spaniel over the weekend who had sustained a mild injury to her right hind limb about a week and a half ago - she is only limping slightly. I discovered a MASSIVE muscle mass difference in her back legs (the left side had much more muscle). Given that she is still using the right leg pretty well, she shouldn't have lost so much muscle in such a short amount of time. This tells me that her "injury" is more chronic and has been going on much longer than originally thought. I'm suspecting a chronic, very mild partial cruciate tear! 

She will be resting for another 3-4 weeks and then we will begin a very slowly progressive exercise program.  The owner would like to try to strengthen up the muscles with the hopes of avoiding a surgery down the line.  I'll keep you posted on her progress!  It should be an interesting case.

Wednesday, May 19, 2010

Breakfast at Ginger's- golden retriever dog eats with hands

This is an adorable and hilarious video that is sure to make you laugh out loud!  Enjoy!  :)

Friday, April 23, 2010

Dog with a possible ACL tear - what can I do?

I often get questions like this about possible cruciate tears and what to do about it, so I thought I'd make this a blog post, rather than just have it in the comment section.  Just like when we injure a joint or muscle, it does take a rest period to allow it to heal.  Let's hope for a minor strain of the muscle or slight sprain of the ligament.  Once the initial pain and inflammation calms down, an orthopedic surgeon (vet) can fully access the knee and determine if there was an actual tear or not.  Cruciate tears are very common in dogs and by and large, they tend to do well (whether managed conservatively or with surgery).  Some dogs really need the surgery to repair it and others don't.  It's a very individual thing.  I strongly suggest that anyone in this situation seek out a well-respected orthopedic surgeon (rather than relying solely on your regular vet's opinion).  You will get the most accurate and up-to-date information from board-certified orthopedic surgeons who deal with these injuries daily!  Here are Heidi's questions and my response below.

Heidi said...

Hi Julie,

Just found your blog today when googling. My 60 lb mutt injured his leg yesterday, possibly an ACL tear or partial tear. The vet put him on bed rest/pain pills/anti-inflammatories for two weeks, then wants to re-assess. Should I be doing anything in the meantime? Ice? He still seems to be in pain, won't put any weight on his back leg, seems stiff when he moves at all. He was pretty active before and only 3 yrs old, no arthritis or previous injuries. Any suggestions on how to make him more comfortable and speed recovery? I'm not in the Tennessee area, otherwise I'd be on your door step!

Thanks! -- H

April 22, 2010 2:59 PM

Julie Stuart said...

You could ice it. It can't hurt and might help. Though if your dog is pretty hairy, the icing effect probably won't get down to the joint and really make any difference. Icing with dogs works better post-surgery when the leg has been shaved. :) Was the vet pretty confident that it was the knee?

You might try stretching out and massaging his other back leg which is now taking all the extra weight. That will probably feel good to him! If he stands for a while (for example, while eating), will he lower the leg down to the floor or close to the floor? Or is he holding it up tightly to his belly? If he is holding it high, you could try very slowly and gently stretching the thigh back away from the belly (while he is lying on his side and relaxed). If you can do this within his comfort zone (and without moving the painful knee), that could give him some relief.

It sounds to me like the vet is suggesting the right course of action.

Update us again after the 2 weeks of rest (if not before) and let us know how he is doing. Also...what is his name?

Tuesday, April 20, 2010

Welcome to new fans!

Welcome to all of the new fans of Physical Therapy for Animals!  If you haven't already done so, you can join us on Facebook by clicking the link to the right.  Introduce yourself and feel free to ask any questions.

Welcome to our community!

Thursday, April 15, 2010

Post-surgery physical therapy for dogs!

Did you know that implementing physical therapy for dogs immediately following orthopedic surgeries can decrease the recovery time, minimize pain, and result in better outcomes?  It's true! 

It's an outdated practice (but unfortunately, still a very common practice) to immobilize the joint/leg with a thick pressure bandage following cruciate repairs, for example.  Veterinarians use the bandage to reduce swelling to the area, prevent the dog from licking at the incision, to "protect" the joint from moving in an undesirable way (and thereby damaging the surgical repair).  But, there are down sides to the bandage.  I have worked with too many dogs to count who started with the bandage and by the time I convinced the vet to remove them (sometimes a day or two after surgery, sometimes longer), the legs were more painful and had lost range of motion (as compared to dogs that never had a bandage put on in the first place).  And guess what?  The dogs that I have treated post-cruciate repair (without a bandage) didn't damage their repairs or have too much swelling.  In the bandage-free dogs, I kept their range of motion good by starting the ROM either the day of or the first day following surgery.  I found that this decreases the pain level too.  I noticed a BIG difference in pain and irritability to touching the leg between these two groups of dogs.  Overall, I vote for no bandage every time!  If your dog needs a cruciate repair, consider asking your surgeon to leave off the bandage and begin ROM, icing, and weight-bearing exercises the day following surgery! 

Friday, March 26, 2010

Hip dysplasia and physical therapy for dogs

Hip dysplais is very common in dogs, in particular in large breeds such as golden retrievers, mastiffs, rotweillers, saint bernards, and labrador retrievers.  Canine hip dysplasia is an orthopedic malformation of the hip joint, which leads to looseness in the joint. This laxity in joints can cause pain  (particularly with hip extension, which is when the dog stretches the leg back hehind him/her and with increased weightbearing, such as when going upstairs).  The laxity often causes increased wear and tear on the joint, which can result in cartilage damage over time.  Arthritis often sets in, and when it does, it can become very painful and result in extreme limping.  A dog may choose to lie around, not want to play fetch as much, and may choose to not go upstairs anymore.  If very severe, the dog may choose to not even use the leg. 

If you see any of these signs, your dog might have hip dysplasia:  decreased activity; difficulty rising after lying down for a while; hind limb lameness or limping; reluctance to use stairs, particularly to go up; reluctance to jump or stand on hind limbs; bunny-hopping gait; a waddling gait; or pain if you try to move the hip/leg back behind in the dog into the motion that is called hip extension. 

If your dog has hip dysplasia, there are a few different surgical options.  But, I have found that physical therapy can make a massive difference in these dogs and in many cases, surgery can be avoided.  When I say "physical therapy" in this case, I am referring primarily to a specific exercise program tailored to your individual dog's needs.  Typically, the exercise program is followed daily or every other day.  But, it really is based on the dog's tolerance - how he/she responds to the exercise type and amount.  If implemented very thoughtfully and carefully by an experienced canine physical therapist, this type of program can be extremely effective. 

The exercise program involves choosing the best type(s) of exercise and slowly increasing the amount, all while "listening" to the dog about how it feels to the hips (both during and after the exercise session).  It also involves regular exercise sessions as opposed to the "weekend warrior" mentality of doing nothing during the week and then a lot on the weekend.  The exercise program, in many cases, can be as simple as starting with a short walk on a leash.  This might be a one minute walk for a very deconditioned, obese, or painful dog.  Or it might be 5-10 minutes for another dog.  It's all dependent on previous activity level, the current conditioning level of the dog, how he/she responds to it, and other factors.  The surface the dog walks on is relevant too.  And almost always, part of the program is to eliminate all of the irritating activities the dog is currently doing that result in pain and inflammation.  Your dog's physical therapist can explain these irritating factors in detail. 

In a nutshell, the pain-inflammation-pain cycle needs to be broken, while also increasing the exercise to strengthen the muscles around the hips.  If we can strengthen those muscles around the hips, that adds stability to the joints and can often be enough to prevent the need for surgery.  But, the muscles need to gain strength via increased exercise and it is necessary to maintain that strength with a maintenance exercise program for life.  The trick is to break the cycle of irritation and find an exercise that works for your dog (without causing further irritation).  Many - I would say, most - dogs can do this by leash walking.  But, for some dogs, the weightbearing is just too painful and causes too much irritation for the joints.  Swimming is an excellent type of exercise for dogs who really need a non-weightbearing form of exercise.  Swimming is actually great for almost all hip dysplasia dogs.  But, my point is that swimming is not always necessary.  Many people do not have access to a place to swim their dogs.  So, just know that in most cases, it is do-able to implement an effective exercise program for dogs with hip dysplasia with walking as the primary form of exercise. 

I often use massage and icing with these dogs too.  Massage because it simply feels good and relaxes the muscles.  And I use ice when the dog shows an increased pain level, which can happen if we do too much exercise too quickly, if the dog gets off leash and runs after that squirrel, if the dog tweaks the hip somehow, etc.  Sometimes when pain and inflammation flare up, we have to begin icing and back off the exercise and then once better, reassess the situation and readjust the type and amount of exercise.  It's definitely a trial and error type of situation - but in my experience, with a commitment to figure it out and follow through with the exercise prescriptions, most dog owners end up happy and so do their dogs! 

I have to say though that dogs tend to do really well with the FHO (femoral head osteotomy) if the pain is just too great and surgery is necessary.  From my experience, extreme care needs to be taken when considering a total hip replacement for your dog.  Different surgeons have different techniques and varying success rates.  So, do your research!  I would just suggest trying the physical therapy/formal exercise program first.  And if it doesn't work out, surgery can be a good second choice.  My 12-year-old golden, Tucker, is still truckin' along and he was diagnosed as a puppy with an extremely severe case of hip dysplasia.  Being an avid tennis ball fetcher made his hips really strong and prevented the need for surgery!  This is actually a good example for us.  He built up to about 10 minutes of running after balls.  That was usually his limit.  If we did more, he got sore.  So, for years, we did 5-10 minutes of running after balls, twice per day.  That is what worked well for him.  But, remember that every dog is different!  A slow 30 minute walk each day may be what works for your dog.  You just don't know until we try different approaches and find something that works.  But, with a great dog owner who is committed to figuring it out and keeping a log to track the exercise and dog's tolerance level, it can usually work out well with just one initial visit, regular contact via phone or email with your physical therapist to make adjustments to the program as needed, and occasional checkups (perhaps weekly for the first month and then less often once a good program is established).  So, it is also a very affordable approach in comparison to surgery!

This is a topic that I could write endlessly about - there really are so many factors to go into the mix, which is why I recommend an experienced canine physical therapist to help you achieve success with your dog! 

Best of luck!  Post comments if you have questions or comments.  Thanks!