Therapy after HBC injuries

[Guest guest]

On February 17. Sadie mond is a 6 1/2 year old, mix breed K-9. She

presented to our clinic after being HBC. She was evaluated at her regular

veterinary clinic and treated with fluid, Solu Delta and ketoprofen. Radiographs

were completed and no thoracic injury was noted and the diaphragm appears to be

intact. Abdominal radiiographs identify abdominal herniation and a right

acetabular fracture with a right coxofemoral luxation and a tail fracture with

displacement. Sadie was transferred to our practice for further evaluation and

care.

After one month of hospitalization, several ultrasounds, and several surgeries,

she went through this last surgery to release her contracted scar on her right

rear leg with the following report.

Medications

***Gabapentin 100mg Cap #60

Rx: Give 1 capsule(s) in the morning and 1 capsule(s) in the evening until gone.

History:

Sadie is in for evaluation and surgical treatment of the contracted scar on the

right rear leg.

Physical Examination

Temperature: 100.8, Weight: 18.636 kg, 41.00 lb, 0.70 m2, Appearance: Bright,

Alert, and Responsive, Mucous Membranes: pink, Capillary Refill Time: <2 sec.

The heart and lungs were ausculted and sounded normal.

Primary Problem: Contracture of the right rear leg due to scar formation. No

further abnormalities found.

Final Diagnosis

Contracture of the right rear leg due to scar tissue formation. A Z-plasty was

performed to free the leg for better extension.

Anesthesia

Pre-med: Morphine (15 mg-ml) .65 mls. SQ, Acepromazine (10mg-ml) .05 mls. SQ,

Induction: Propofol (10 mg-ml) 5 mls. IV,

Maintenance: Isoflurane,

Intra-op fluids: CRI (Ketamine,Morphine,Lidocaine) in LRS 300 mls. IV

Post-op Pain Medication: Morphine (15 mg-ml) .65 mls. SQ,

Recovery: Uneventful.

Surgical Procedure

An elliptical incision was made around the scar tissue. The scar was partially

removed. The incision was extended proximally and distally. A 60 degree z

incision was made at each end of the central incision. The skin was elevated to

free it for more mobility. The incision was closed with 2-0 pds to give better

leg extension.

Sadie is fully recovered from all procedures and ready to start rehab. She has

limited ROM on the right rear leg. She is a VERY touch me not patient when it

comes to that leg. I am unable to get her ROM measurements. She is walking on

the right rear leg but, holds it up when trotting. She did well in the UWTM for

the first time today. I would appreciate any and all suggestion on ways to

regain her ROM. Would E-STEM be beneficial in this patient?

* I have pictures and video of her walking on request. (not sure how to attach

onto here)