Guest guest Posted January 8, 2009 Report Share Posted January 8, 2009 Have there been diagnostics done? CT, MRI, rads? Sounds like a torticollis... Amie Amie Lamoreaux Hesbach, MSPT, CCRP, CCRT Next Step Animal Rehabilitation & Fitness, LLC Huntingtown, land USA www.vetmash.com neuro case Hey everyone, I currently have an 8 wk. old F Golden puppy who unfortunately got her head closed in a recliner on New Year's Day - she presented to me (DVM)obtunded, and laterally recumbent - I treated her for head trauma through the nite and noticed a developed head TURN to the left, L HL flexion, and R HL extension, FLs were WNL, deep pain x 4, withdrawal x 4). Besides the limb issues we treated the mentation changes and she recovered beautifully -- PLRs intact, no menace (no surprise), but believe she is blind - hopefully temporarily, but I am now working on PT -- she does not stand, prefers to lay on her right side with the significant head turn to the left - I can place her on the left side and she will lie comfortably with her head in neutral - When I attmept her to stand, her head immediately snaps to the left, and previously the R HL stayed in complete extension (now improved to point of standing on limb)- the remaining limbs will actually place to the ground normally but that L HL wants to continue to flex all the way to her body while her head wants to remain tucked to her Left side. (xrays were done to confirm NO fractures of vertebral bodies) My PT involves working of the right side of the neck to release tension there, and at the same time PNFs of limbs and back - vibratory massage, ROM exercises, assist to standing while trying to bring head to neutral, -- FLS doing ok, -- she cannot support her own head weight and is limp in my hands with her head turn. She tries to take steps but the back end is not together and she immediately circles to the left tightly. Ahy thoughts, suggestions, etc? Bit involved so please feel free to email questions -- thanks so much -- Jacqui Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 8, 2009 Report Share Posted January 8, 2009 xrays reveal no abnormalities - no fractures seen - CT/MRI cannot be afforded at this time --- To: VetRehab From: forpawsrehab@...Date: Thu, 8 Jan 2009 16:40:17 +0000Subject: Re: neuro case Have there been diagnostics done? CT, MRI, rads?Sounds like a torticollis...AmieAmie Lamoreaux Hesbach, MSPT, CCRP, CCRTNext Step Animal Rehabilitation & Fitness, LLCHuntingtown, land USAwww.vetmash.com neuro caseHey everyone, I currently have an 8 wk. old F Golden puppy who unfortunately got her head closed in a recliner on New Year's Day - she presented to me (DVM)obtunded, and laterally recumbent - I treated her for head trauma through the nite and noticed a developed head TURN to the left, L HL flexion, and R HL extension, FLs were WNL, deep pain x 4, withdrawal x 4). Besides the limb issues we treated the mentation changes and she recovered beautifully -- PLRs intact, no menace (no surprise), but believe she is blind - hopefully temporarily, but I am now working on PT -- she does not stand, prefers to lay on her right side with the significant head turn to the left - I can place her on the left side and she will lie comfortably with her head in neutral - When I attmept her to stand, her head immediately snaps to the left, and previously the R HL stayed in complete extension (now improved to point of standing on limb)- the remaining limbs will actually place to the ground normally but that L HL wants to continue to flex all the way to her body while her head wants to remain tucked to her Left side. (xrays were done to confirm NO fractures of vertebral bodies) My PT involves working of the right side of the neck to release tension there, and at the same time PNFs of limbs and back - vibratory massage, ROM exercises, assist to standing while trying to bring head to neutral, -- FLS doing ok, -- she cannot support her own head weight and is limp in my hands with her head turn. She tries to take steps but the back end is not together and she immediately circles to the left tightly. Ahy thoughts, suggestions, etc? Bit involved so please feel free to email questions -- thanks so much -- Jacqui Invite your mail contacts to join your friends list with Windows Live Spaces. It's easy! Try it! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 10, 2009 Report Share Posted January 10, 2009 Do you have craniosacral therapist in your area or PTt that specializes with Bobath techniqes might be really helpful! Glad the puppy is getting better- I have been thinker of her since your post and also hoping to hear more opinions form Neuro canine experts. Rosemary This is great - giving all an update - puppy "walked" today -- held head in one hand and tail in the other - she definitely took steps and walked with support in a large circle - I am currently using moist heat on the neck and then some mm. massage to help her head turn, but I am seeing improvements daily. Any neuro people out there with other thoughts? Jacqui To: VetRehab From: rmheg@...Date: Thu, 8 Jan 2009 23:32:58 -0500Subject: Re: neuro case I don't know anything about the canine primitive reflexes but it sounds like the puppy might be demonstrating some primitive reflexes that we commonly see with human head injuries- when the higher level neuro pathways are damaged or disrupted you see primitive reflexes for example ATNR (turning head to one side causes upper extremity to extend to opposite side) return - they are no longer inhibited by the higher neuro function that has been damaged.??? Rosemary In a message dated 1/8/2009 7:39:12 A.M. Pacific Standard Time, j.luchina writes: Hey everyone, I currently have an 8 wk. old F Golden puppy who unfortunately got her head closed in a recliner on New Year's Day - she presented to me (DVM)obtunded, and laterally recumbent - I treated her for head trauma through the nite and noticed a developed head TURN to the left, L HL flexion, and R HL extension, FLs were WNL, deep pain x 4, withdrawal x 4). Besides the limb issues we treated the mentation changes and she recovered beautifully -- PLRs intact, no menace (no surprise), but believe she is blind - hopefully temporarily, but I am now working on PT -- she does not stand, prefers to lay on her right side with the significant head turn to the left - I can place her on the left side and she will lie comfortably with her head in neutral - When I attmept her to stand, her head immediately snaps to the left, and previously the R HL stayed in complete extension (now improved to point of standing on limb)- the remaining limbs will actually place to the ground normally but that L HL wants to continue to flex all the way to her body while her head wants to remain tucked to her Left side. (xrays were done to confirm NO fractures of vertebral bodies) My PT involves working of the right side of the neck to release tension there, and at the same time PNFs of limbs and back - vibratory massage, ROM exercises, assist to standing while trying to bring head to neutral, -- FLS doing ok, -- she cannot support her own head weight and is limp in my hands with her head turn. She tries to take steps but the back end is not together and she immediately circles to the left tightly. Ahy thoughts, suggestions, etc? Bit involved so please feel free to email questions -- thanks so much -- Jacqui A Good Credit Score is 700 or Above. See yours in just 2 easy steps! What can you do with the new Windows Live? Find out A Good Credit Score is 700 or Above. See yours in just 2 easy steps! Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 11, 2009 Report Share Posted January 11, 2009 Thanks Rosemary - I'm currently looking into finding a craniosacral therapist in my area at this time - I thank you for your support and thoughts - I too am awaiting to hear (hopefully) from some neuro people out there too....... Anyone? Jacqui To: VetRehab From: rmheg@...Date: Sat, 10 Jan 2009 12:08:10 -0500Subject: Re: neuro case Do you have craniosacral therapist in your area or PTt that specializes with Bobath techniqes might be really helpful! Glad the puppy is getting better- I have been thinker of her since your post and also hoping to hear more opinions form Neuro canine experts. Rosemary In a message dated 1/9/2009 4:57:12 A.M. Pacific Standard Time, Jacteeshotmail writes: This is great - giving all an update - puppy "walked" today -- held head in one hand and tail in the other - she definitely took steps and walked with support in a large circle - I am currently using moist heat on the neck and then some mm. massage to help her head turn, but I am seeing improvements daily. Any neuro people out there with other thoughts? Jacqui To: VetRehab From: rmheg@...Date: Thu, 8 Jan 2009 23:32:58 -0500Subject: Re: neuro case I don't know anything about the canine primitive reflexes but it sounds like the puppy might be demonstrating some primitive reflexes that we commonly see with human head injuries- when the higher level neuro pathways are damaged or disrupted you see primitive reflexes for example ATNR (turning head to one side causes upper extremity to extend to opposite side) return - they are no longer inhibited by the higher neuro function that has been damaged.??? Rosemary In a message dated 1/8/2009 7:39:12 A.M. Pacific Standard Time, j.luchina writes: Hey everyone, I currently have an 8 wk. old F Golden puppy who unfortunately got her head closed in a recliner on New Year's Day - she presented to me (DVM)obtunded, and laterally recumbent - I treated her for head trauma through the nite and noticed a developed head TURN to the left, L HL flexion, and R HL extension, FLs were WNL, deep pain x 4, withdrawal x 4). Besides the limb issues we treated the mentation changes and she recovered beautifully -- PLRs intact, no menace (no surprise), but believe she is blind - hopefully temporarily, but I am now working on PT -- she does not stand, prefers to lay on her right side with the significant head turn to the left - I can place her on the left side and she will lie comfortably with her head in neutral - When I attmept her to stand, her head immediately snaps to the left, and previously the R HL stayed in complete extension (now improved to point of standing on limb)- the remaining limbs will actually place to the ground normally but that L HL wants to continue to flex all the way to her body while her head wants to remain tucked to her Left side. (xrays were done to confirm NO fractures of vertebral bodies) My PT involves working of the right side of the neck to release tension there, and at the same time PNFs of limbs and back - vibratory massage, ROM exercises, assist to standing while trying to bring head to neutral, -- FLS doing ok, -- she cannot support her own head weight and is limp in my hands with her head turn. She tries to take steps but the back end is not together and she immediately circles to the left tightly. Ahy thoughts, suggestions, etc? Bit involved so please feel free to email questions -- thanks so much -- Jacqui A Good Credit Score is 700 or Above. See yours in just 2 easy steps! What can you do with the new Windows Live? Find out A Good Credit Score is 700 or Above. See yours in just 2 easy steps! See all the ways you can stay connected to friends and family Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 11, 2009 Report Share Posted January 11, 2009 I totally agree that a craniosacral person could be a boon for this little one. It can bring even more miraculous progress to this journey! I hope you have the joy of doing some of this therapy on the puppy yourself, and this case will give you such great feedback in "feel" about the inner workings of the recovering nervous system, as I know it already has! I am glad that some of our experienced friends here are explaining some of what's going on as you give us updates, I hope that the neuro-knowledgeable, especially those with some human neuro rehab information will continue to reply. I am so glad that it's doing better! This accident pulls at one's feelings. My heart goes out to whoever was in that recliner! I know they probably feel worse than the bounce-back puppy!!! Humans are the only creatures that give "meaning" to pain!! The animals use it as information to heal and grow the best way they can, no matter what has caused it!Judith M. Shoemaker, DVMAlways Helpful Veterinary Services305 Nottingham RoadNottingham, PA 19362ph fax info@... www.judithshoemaker.com To: VetRehab From: rmheg@...Date: Sat, 10 Jan 2009 12:08:10 -0500Subject: Re: neuro case Do you have craniosacral therapist in your area or PTt that specializes with Bobath techniqes might be really helpful! Glad the puppy is getting better- I have been thinker of her since your post and also hoping to hear more opinions form Neuro canine experts. Rosemary In a message dated 1/9/2009 4:57:12 A.M. Pacific Standard Time, Jacteeshotmail writes: This is great - giving all an update - puppy "walked" today -- held head in one hand and tail in the other - she definitely took steps and walked with support in a large circle - I am currently using moist heat on the neck and then some mm. massage to help her head turn, but I am seeing improvements daily. Any neuro people out there with other thoughts? Jacqui To: VetRehab From: rmheg@...Date: Thu, 8 Jan 2009 23:32:58 -0500Subject: Re: neuro case I don't know anything about the canine primitive reflexes but it sounds like the puppy might be demonstrating some primitive reflexes that we commonly see with human head injuries- when the higher level neuro pathways are damaged or disrupted you see primitive reflexes for example ATNR (turning head to one side causes upper extremity to extend to opposite side) return - they are no longer inhibited by the higher neuro function that has been damaged.??? Rosemary In a message dated 1/8/2009 7:39:12 A.M. Pacific Standard Time, j.luchina writes: Hey everyone, I currently have an 8 wk. old F Golden puppy who unfortunately got her head closed in a recliner on New Year's Day - she presented to me (DVM)obtunded, and laterally recumbent - I treated her for head trauma through the nite and noticed a developed head TURN to the left, L HL flexion, and R HL extension, FLs were WNL, deep pain x 4, withdrawal x 4). Besides the limb issues we treated the mentation changes and she recovered beautifully -- PLRs intact, no menace (no surprise), but believe she is blind - hopefully temporarily, but I am now working on PT -- she does not stand, prefers to lay on her right side with the significant head turn to the left - I can place her on the left side and she will lie comfortably with her head in neutral - When I attmept her to stand, her head immediately snaps to the left, and previously the R HL stayed in complete extension (now improved to point of standing on limb)- the remaining limbs will actually place to the ground normally but that L HL wants to continue to flex all the way to her body while her head wants to remain tucked to her Left side. (xrays were done to confirm NO fractures of vertebral bodies) My PT involves working of the right side of the neck to release tension there, and at the same time PNFs of limbs and back - vibratory massage, ROM exercises, assist to standing while trying to bring head to neutral, -- FLS doing ok, -- she cannot support her own head weight and is limp in my hands with her head turn. She tries to take steps but the back end is not together and she immediately circles to the left tightly. Ahy thoughts, suggestions, etc? Bit involved so please feel free to email questions -- thanks so much -- Jacqui A Good Credit Score is 700 or Above. See yours in just 2 easy steps! What can you do with the new Windows Live? Find out A Good Credit Score is 700 or Above. See yours in just 2 easy steps! Windows Live™: Keep your life in sync. Check it out. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 20, 2009 Report Share Posted January 20, 2009 Hi Jacqui, I just arrived back from India and am going through about two weeks of e-mail so I apologize if I'm jumping into the middle of this conversation but I haven't combed through all the e-mails yet. I agree with Rosemary that the initial L HL flxn and R HL ext with the L head turn does sound like a primitive human reflex. This almost sounds similar to decorticate posturing.(decerebrate posturing would be where both hindlimbs are flexed). I'm wondering what happens when the dog's head is turned to the right? Do you see a change in the hindlimb positions? I think someone mentioned Bobath techniques. That is one approach I would integrate into what you are doing. Specifically, I would use dissociative techniqes or some might say "reflex inhibiting" but I usually don't use that term. Simply put, placing the dog in her 'developmental positions' (sternal sit, tall sit, and standing) and manually correcting abnormalities or building in pieces that are not present is a good place to start. Passively place the dog in a sternal position. What does she look like. Is she able to maintian this position with neck in neutral position (not turned to the left or right and not hyperextended)? If not, manually place the dog in the correct position. This may take some creative body mechanics on your part and may also require an additional therapist/person to assist. Also, use the resistance from the ground to your advantage. If the dog can maintain the position with her head in neutral, but when head is turned to the left, extends the right hind limb, manually keep the right leg in a flexed position. The right leg may try to extend but use manual force to maintain the position. This maintenance of the sternal position, coupled with the reaction force from the floor will allow you to counteract the primitive reflex. I would work in this manner for the remainder of the positions following a progression of passively placing the dog in each developmental position, using manual techniques as well as environmental factors (i.e. the floor, bracing, peanut ball) to 'inhibit' or decrease the unwanted motion and finally work the dog up to actively moving against the unwanted position. For example, help the dog to maintain the sternal position, decrease the ability of the rigth hind leg to flex, then actively ask the dog to turn her head to the right and left to retrieve a treat. (Of course I wouldn't expect this in one session, in humans this occurs over the course of weeks to months depending on the injury, but I have been amazed at the ability of the dog's to respond to neuro therapies usually in a shorter time frame than the humans I've seen). I would continue like this for all positions. In standing you may need to employ some type of standing brace (I make mine out of semi-rigid cast material) if you can't counteract the flexion of the right hind leg, or manual force may be enough. Using a peanut ball for support may also help. Make sure the trunk is maintained in a neutral position (i.e.no curving) during all of these positions/techniques as I have seen lots of compensations at the trunk. Again, in standing, work on passively maintaining the position, to having the dog actively maintain the position, to having the dog actively work in the position. In terms of gait training, I would get stool on wheels and walk next to the dog, providing manual cues to maintain the trunk in neutral alignment. If the dog habitually walks in a circle you may see some compensatory hip adduction as the dog tries to maitain her center of gravity over her base of support. So those are just my rough outlines in terms of starting with the developmental positions, decreasing the undesirable motions/reflexes, building in desirable postures and responses, and working for active motion. As always, massage, soft tissue work due to the reflexes causing excessive compensatory tightening would also be performed. Vet chiro may be warranted also. Feel free to e-mail me off line if you have any questions or need further ideas, this is just kind of a blue print and if the dog progresses quickly there are plenty of higher level techniques we can add to this. These are my favorite kind of patients to work with and I always hope that if the owners can see some progress they will continue to pursue treatment. Every case is unique of course, but I see some of these dogs with neuro injuries that have great potential and progress rather quickly (as compared to humans who eventually have pretty decent outcomes) but I think a lot of times their treatments are stopped before significant progress is made due to financial concerns or lack of returning to 'normal' quickly enough so I just want to help in any way I can. Jeanine Freeberg PT, DPT Subject: RE: neuro caseTo: vetrehab Date: Sunday, January 11, 2009, 9:35 AM Thanks Rosemary - I'm currently looking into finding a craniosacral therapist in my area at this time - I thank you for your support and thoughts - I too am awaiting to hear (hopefully) from some neuro people out there too....... Anyone? Jacqui To: VetRehab@yahoogroup s.comFrom: rmheg@...Date: Sat, 10 Jan 2009 12:08:10 -0500Subject: Re: neuro case Do you have craniosacral therapist in your area or PTt that specializes with Bobath techniqes might be really helpful! Glad the puppy is getting better- I have been thinker of her since your post and also hoping to hear more opinions form Neuro canine experts. Rosemary In a message dated 1/9/2009 4:57:12 A.M. Pacific Standard Time, Jacteeshotmail (DOT) com writes: This is great - giving all an update - puppy "walked" today -- held head in one hand and tail in the other - she definitely took steps and walked with support in a large circle - I am currently using moist heat on the neck and then some mm. massage to help her head turn, but I am seeing improvements daily. Any neuro people out there with other thoughts? Jacqui To: VetRehab@yahoogroup s.comFrom: rmheg@...Date: Thu, 8 Jan 2009 23:32:58 -0500Subject: Re: neuro case I don't know anything about the canine primitive reflexes but it sounds like the puppy might be demonstrating some primitive reflexes that we commonly see with human head injuries- when the higher level neuro pathways are damaged or disrupted you see primitive reflexes for example ATNR (turning head to one side causes upper extremity to extend to opposite side) return - they are no longer inhibited by the higher neuro function that has been damaged.??? Rosemary In a message dated 1/8/2009 7:39:12 A.M. Pacific Standard Time, j.luchinayahoo (DOT) com writes: Hey everyone, I currently have an 8 wk. old F Golden puppy who unfortunately got her head closed in a recliner on New Year's Day - she presented to me (DVM)obtunded, and laterally recumbent - I treated her for head trauma through the nite and noticed a developed head TURN to the left, L HL flexion, and R HL extension, FLs were WNL, deep pain x 4, withdrawal x 4). Besides the limb issues we treated the mentation changes and she recovered beautifully -- PLRs intact, no menace (no surprise), but believe she is blind - hopefully temporarily, but I am now working on PT -- she does not stand, prefers to lay on her right side with the significant head turn to the left - I can place her on the left side and she will lie comfortably with her head in neutral - When I attmept her to stand, her head immediately snaps to the left, and previously the R HL stayed in complete extension (now improved to point of standing on limb)- the remaining limbs will actually place to the ground normally but that L HL wants to continue to flex all the way to her body while her head wants to remain tucked to her Left side. (xrays were done to confirm NO fractures of vertebral bodies) My PT involves working of the right side of the neck to release tension there, and at the same time PNFs of limbs and back - vibratory massage, ROM exercises, assist to standing while trying to bring head to neutral, -- FLS doing ok, -- she cannot support her own head weight and is limp in my hands with her head turn. She tries to take steps but the back end is not together and she immediately circles to the left tightly. Ahy thoughts, suggestions, etc? Bit involved so please feel free to email questions -- thanks so much -- Jacqui A Good Credit Score is 700 or Above. See yours in just 2 easy steps! What can you do with the new Windows Live? Find out A Good Credit Score is 700 or Above. See yours in just 2 easy steps! See all the ways you can stay connected to friends and family Quote Link to comment Share on other sites More sharing options...
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