Re: Leg Tremor

[Guest guest]

Gosh Mark,I can't say I've ever seen this, and I've been rehabbing stilfes for over 10 years, from TTAs to LFS procedures-I'd love to see what this looks like-is is all day, whenever the dog stands?

 

Evening from Oregon1

What are anyone's thoughts on the cause of leg tremoring I have seen occasionally weeks post-op on knee surgeries? The patients seem to be doing well but then within a few weeks they begin to have tremors in the operated hind leg at a stand. I thought there was a post on this awhile back. Owners are concerned about pain but the patients are increasing their weight bearing and are more comfortable on the op-leg. I have always thought it was that they were increasing the use of muscles that had been atrophied thru disuse and the tremoring is due to muscle fatigue. However that does not really explain it when they stand and have not been exercising or rehabbing and the tremor occurs. With several weeks to months, the tremoring resolves with no specific treatment. Anyones thoughts?

thanks,

Mark b. Parchman, DVM, DACVS, CVA, CCRT

[Guest guest]

Mark, I see that you are CVA.  I have had a dog with a similar issue, although his was more prominent in recumbency.  He responded within hours to acupuncture at KI 1 and ba feng on that leg..leading me to believe there was a loss of neurological talk somewhere along the line. 

You didn't mention the type of knee surgery, but TPLO's can severely disrupt the nerve supply/channels to the lower leg.  Good luck, Mike

 

Evening from Oregon1

What are anyone's thoughts on the cause of leg tremoring I have seen occasionally weeks post-op on knee surgeries?

-- Mike Petty, DVMDiplomate, American Academy of Pain ManagementCertified Medical Veterinary AcupuncturistPresident-Elect, International Veterinary Academy of Pain Management

Arbor Pointe Veterinary HospitalCanton, MI

[Guest guest]

I just looked at my notes.  The dog responded to acupuncture within 36 hours the first time, and within the same day on follow up treatments.

 

Mark,

I think you are on the right track regarding muscle fatigue. To compensate for the articular dysfunction created by both the injury and subsequent trauma of surgery limited weight bearing in the hind limb is accomplished by submaximal contraction of the flexors of the hip and to much less degree flexors of the stifle. The iliopsoas complex, m. sartorius, m. tensor fascia latae and m. rectus femoris never really get a chance to rest and additionally are often overloaded during ambulation. This overload situation is brought about during ambulation by increased flexion of the hip and decrease flexion of the stifle. In these patients the muscle mentioned above will often form myofascial trigger points and thus become painful and shorter. The resulting posture is often a kyphosis of the thoracolumbar spine and limited extension of the hind limb during ambulation.

You might try examining these muscles for pain. I also recommend passive stretching of the ilopsoas in addition to the hip and stifle.

Rick Wall

-- Mike Petty, DVMDiplomate, American Academy of Pain ManagementCertified Medical Veterinary AcupuncturistPresident-Elect, International Veterinary Academy of Pain Management

Arbor Pointe Veterinary HospitalCanton, MI

[Guest guest]

Mark,

I think you are on the right track regarding muscle fatigue. To compensate for

the articular dysfunction created by both the injury and subsequent trauma of

surgery limited weight bearing in the hind limb is accomplished by submaximal

contraction of the flexors of the hip and to much less degree flexors of the

stifle. The iliopsoas complex, m. sartorius, m. tensor fascia latae and m.

rectus femoris never really get a chance to rest and additionally are often

overloaded during ambulation. This overload situation is brought about during

ambulation by increased flexion of the hip and decrease flexion of the stifle.

In these patients the muscle mentioned above will often form myofascial trigger

points and thus become painful and shorter. The resulting posture is often a

kyphosis of the thoracolumbar spine and limited extension of the hind limb

during ambulation.

You might try examining these muscles for pain. I also recommend passive

stretching of the ilopsoas in addition to the hip and stifle.

Rick Wall