Rehab for Leonberger with bilateral RCCLs and spondylosis

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Hello All,

I have an interesting case. A 10 year old spayed/female Leonberger who has ruptured CCLs bilaterally (old injuries diagnosed recently on rads) as well as significant spondylosis in lower thoracic and lumbar spine. This dog does not have neurologic deficits, but she does have bilateral pelvic limb muscle atrophy and weakness and is overweight. She has trouble getting up on hardwoods (wears Pawz booties) tires quickly on leash walks, can't jump into car and sometimes doesn't want to walk (the typical clinical manifestation of older dog with rCCLs and spondylosis.) However, she does get around pretty well, no knuckling, no scraping of her toe-nails on digits #3 and #4 on pelvic limbs and can sit straight with stifles in decent flexion.

The interesting thing is that she does much worse in the UWTM. We have been doing strengthening exercises and UWTM for rehab. However when in the UWTM, Lulu drops her pelvic limbs early, frequently knuckles and walks much worse than on land. I have tried tail stim, bottom's up attached to PVC piping to support pelvic limbs but it hasn't helped. It appears that the resistance of the water and the discomfort associated with stifle extension creates this problem. However, the benefits of UWTM are obvious and the owners would love to continue if we could think of a way to make it work for her. Any ideas?

Thanks!

Alycia Lamb, DVM, CCRT