Tetraplegic Dobe with neck compression

[Guest guest]

I have been working with a 7 yr old Dobe that is tetraplegic for about 3 weeks.

She came to me after a couple months of dealing with paresis that improved with

pred. When the RDVM decided to decrease her pred he condition deteriorated the

state it is now. I'm dealing with money issues, so don't have as much imaging as

I would like.

I finally talked them into getting neck x-rays. I'm not sure how to post these,

but will keep trying. It appears to me there is compressive lesion maybe from

trauma. This would go with the owner's story that this dog loves to chase cats

and the cats will go thru a small hole in the fence or barn wall. So it's

possible she could have run head-long into a wall.

Her first symptoms seemed to happen about a year ago and she recovered. Within

the last couple of months the owner let her out of her cage. He said she tripped

on the chain-link bar at the bottom of the door and and fell down. He said she's

always been a dog who doesn't like help, so he turned and went on to do his

chores. About 20 min later he noticed that she was still lying where she fell

and that's when the pred treatment started.

I have done massage therapy, laser therapy, and some minor distractions on the

neck. Since I've never done distractions I'm a little tentative. I've used NMES

on the muscles of the left side because her right side seems to be doing better.

I have the family doing flexor reflexes on all 4 legs, PROM and stretching,

sitting her up over a peanut and doing cookies to each side. We also do standing

therapy over the peanut. We've also been putting her in the UWTM twice weekly

with 2 of us doing patterned walking with her.

I don't do acupuncture so it's not readily available when the owner bring her in

for therapy. I've talked to the owners about beginning acupuncture with someone,

but they are reluctant.

This is such a difficult case that I want all suggestions that anyone has. I

have video of her in the UWTM also that I will try to post.

I also feel that the dog is not trying. She is not food motivated, nor does she

seem to be interested in moving. She can control her urine and waits for someone

to take her outside in her Help-Em-Up Harness. When she is ready to urinate she

will lift her rear legs up and apart and lift her tail to take care of business.

When I pinch between her toes she will begin to withdraw and then kick backwards

to get me to let go. Lately she does seem to kick as often or as hard, like

she's just waiting for me to stop rather than put forth the effort to make me

stop.

Any ideas would be greatly appreciated.

Christie Carlo, DVM, CCRT

[Guest guest]

I was unable to upload the videos to Yahoo, but here is a link to my YouTube

account.

I was able to upload the x-rays. I entitled them " Hali " .

Christie Carlo, DVM, CCRT

>

> I have been working with a 7 yr old Dobe that is tetraplegic for about 3

weeks. She came to me after a couple months of dealing with paresis that

improved with pred. When the RDVM decided to decrease her pred he condition

deteriorated the state it is now. I'm dealing with money issues, so don't have

as much imaging as I would like.

>

> I finally talked them into getting neck x-rays. I'm not sure how to post

these, but will keep trying. It appears to me there is compressive lesion maybe

from trauma. This would go with the owner's story that this dog loves to chase

cats and the cats will go thru a small hole in the fence or barn wall. So it's

possible she could have run head-long into a wall.

>

> Her first symptoms seemed to happen about a year ago and she recovered. Within

the last couple of months the owner let her out of her cage. He said she tripped

on the chain-link bar at the bottom of the door and and fell down. He said she's

always been a dog who doesn't like help, so he turned and went on to do his

chores. About 20 min later he noticed that she was still lying where she fell

and that's when the pred treatment started.

>

> I have done massage therapy, laser therapy, and some minor distractions on the

neck. Since I've never done distractions I'm a little tentative. I've used NMES

on the muscles of the left side because her right side seems to be doing better.

I have the family doing flexor reflexes on all 4 legs, PROM and stretching,

sitting her up over a peanut and doing cookies to each side. We also do standing

therapy over the peanut. We've also been putting her in the UWTM twice weekly

with 2 of us doing patterned walking with her.

>

> I don't do acupuncture so it's not readily available when the owner bring her

in for therapy. I've talked to the owners about beginning acupuncture with

someone, but they are reluctant.

>

> This is such a difficult case that I want all suggestions that anyone has. I

have video of her in the UWTM also that I will try to post.

>

> I also feel that the dog is not trying. She is not food motivated, nor does

she seem to be interested in moving. She can control her urine and waits for

someone to take her outside in her Help-Em-Up Harness. When she is ready to

urinate she will lift her rear legs up and apart and lift her tail to take care

of business. When I pinch between her toes she will begin to withdraw and then

kick backwards to get me to let go. Lately she does seem to kick as often or as

hard, like she's just waiting for me to stop rather than put forth the effort to

make me stop.

>

> Any ideas would be greatly appreciated.

>

> Christie Carlo, DVM, CCRT

>

[Guest guest]

Traction traction traction.You have to address the root of the problem before you’ll have any success in tackling the symptoms!JLaurie From: VetRehab [mailto:VetRehab ] On Behalf Of ChristieCSent: December-19-10 8:12 PMTo: VetRehab Subject: Tetraplegic Dobe with neck compression I have been working with a 7 yr old Dobe that is tetraplegic for about 3 weeks. She came to me after a couple months of dealing with paresis that improved with pred. When the RDVM decided to decrease her pred he condition deteriorated the state it is now. I'm dealing with money issues, so don't have as much imaging as I would like.I finally talked them into getting neck x-rays. I'm not sure how to post these, but will keep trying. It appears to me there is compressive lesion maybe from trauma. This would go with the owner's story that this dog loves to chase cats and the cats will go thru a small hole in the fence or barn wall. So it's possible she could have run head-long into a wall.Her first symptoms seemed to happen about a year ago and she recovered. Within the last couple of months the owner let her out of her cage. He said she tripped on the chain-link bar at the bottom of the door and and fell down. He said she's always been a dog who doesn't like help, so he turned and went on to do his chores. About 20 min later he noticed that she was still lying where she fell and that's when the pred treatment started.I have done massage therapy, laser therapy, and some minor distractions on the neck. Since I've never done distractions I'm a little tentative. I've used NMES on the muscles of the left side because her right side seems to be doing better. I have the family doing flexor reflexes on all 4 legs, PROM and stretching, sitting her up over a peanut and doing cookies to each side. We also do standing therapy over the peanut. We've also been putting her in the UWTM twice weekly with 2 of us doing patterned walking with her.I don't do acupuncture so it's not readily available when the owner bring her in for therapy. I've talked to the owners about beginning acupuncture with someone, but they are reluctant.This is such a difficult case that I want all suggestions that anyone has. I have video of her in the UWTM also that I will try to post.I also feel that the dog is not trying. She is not food motivated, nor does she seem to be interested in moving. She can control her urine and waits for someone to take her outside in her Help-Em-Up Harness. When she is ready to urinate she will lift her rear legs up and apart and lift her tail to take care of business. When I pinch between her toes she will begin to withdraw and then kick backwards to get me to let go. Lately she does seem to kick as often or as hard, like she's just waiting for me to stop rather than put forth the effort to make me stop.Any ideas would be greatly appreciated.Christie Carlo, DVM, CCRT __________ Information from ESET NOD32 Antivirus, version of virus signature database 5716 (20101219) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com __________ Information from ESET NOD32 Antivirus, version of virus signature database 5716 (20101219) __________The message was checked by ESET NOD32 Antivirus.http://www.eset.com

[Guest guest]

Laurie - Please describe in detail how I should do traction for a caudal

cervical lesion. Would it be better with 1 or 2 people? Would it be best with

the dog lying on her side or sternal? Where is the best place to hold (back of

skull, on the cranial neck, on the scapulas, mid-thorax)? How slowly and hold

for how long? I gently tried this once and I could tell the owner was extremely

nervous so I didn't do as much as I probably would have without the owner in the

room.

Thanks for your advise.

Christie Carlo, DVM, CCRT

>

> Traction traction traction.

>

> You have to address the root of the problem before you'll have any success

> in tackling the symptoms!

>

> J

>

> Laurie

>

>

>

> From: VetRehab [mailto:VetRehab ] On Behalf

> Of ChristieC

> Sent: December-19-10 8:12 PM

> To: VetRehab

> Subject: Tetraplegic Dobe with neck compression

>

>

>

>

>

> I have been working with a 7 yr old Dobe that is tetraplegic for about 3

> weeks. She came to me after a couple months of dealing with paresis that

> improved with pred. When the RDVM decided to decrease her pred he condition

> deteriorated the state it is now. I'm dealing with money issues, so don't

> have as much imaging as I would like.

>

> I finally talked them into getting neck x-rays. I'm not sure how to post

> these, but will keep trying. It appears to me there is compressive lesion

> maybe from trauma. This would go with the owner's story that this dog loves

> to chase cats and the cats will go thru a small hole in the fence or barn

> wall. So it's possible she could have run head-long into a wall.

>

> Her first symptoms seemed to happen about a year ago and she recovered.

> Within the last couple of months the owner let her out of her cage. He said

> she tripped on the chain-link bar at the bottom of the door and and fell

> down. He said she's always been a dog who doesn't like help, so he turned

> and went on to do his chores. About 20 min later he noticed that she was

> still lying where she fell and that's when the pred treatment started.

>

> I have done massage therapy, laser therapy, and some minor distractions on

> the neck. Since I've never done distractions I'm a little tentative. I've

> used NMES on the muscles of the left side because her right side seems to be

> doing better. I have the family doing flexor reflexes on all 4 legs, PROM

> and stretching, sitting her up over a peanut and doing cookies to each side.

> We also do standing therapy over the peanut. We've also been putting her in

> the UWTM twice weekly with 2 of us doing patterned walking with her.

>

> I don't do acupuncture so it's not readily available when the owner bring

> her in for therapy. I've talked to the owners about beginning acupuncture

> with someone, but they are reluctant.

>

> This is such a difficult case that I want all suggestions that anyone has. I

> have video of her in the UWTM also that I will try to post.

>

> I also feel that the dog is not trying. She is not food motivated, nor does

> she seem to be interested in moving. She can control her urine and waits for

> someone to take her outside in her Help-Em-Up Harness. When she is ready to

> urinate she will lift her rear legs up and apart and lift her tail to take

> care of business. When I pinch between her toes she will begin to withdraw

> and then kick backwards to get me to let go. Lately she does seem to kick as

> often or as hard, like she's just waiting for me to stop rather than put

> forth the effort to make me stop.

>

> Any ideas would be greatly appreciated.

>

> Christie Carlo, DVM, CCRT

>

>

>

>

>

> __________ Information from ESET NOD32 Antivirus, version of virus signature

> database 5716 (20101219) __________

>

>

>

> The message was checked by ESET NOD32 Antivirus.

>

>

>

> http://www.eset.com

>

[Guest guest]

Thought you might enjoy seeing our current quad on the BWST. Comments are

welcome.

Rick Wall

http://vimeo.com/18034596

[Guest guest]

Hi Christie- Where did you post the xrays?  I didn't see them.  I just took Laurie's PT course.  We did neck traction a number of different ways.  One way was to have someone hold the shoulders and then the 2nd person pushes the head cranially holding right behind the skull, that might work- but if there really is a fracture, I might be worried too about the fracture moving and impacting the spinal cord.  Could there have been some pathology in the bone before hand like multiple myeloma do you think? Or do you think it was all trauma? 

Hershey, DVM

 

I was unable to upload the videos to Yahoo, but here is a link to my YouTube account.http://www.youtube.com/watch?v=p_rmqB4N4Dchttp://www.youtube.com/watch?v=yrAZcFOK0QM

I was able to upload the x-rays. I entitled them " Hali " .Christie Carlo, DVM, CCRT >> I have been working with a 7 yr old Dobe that is tetraplegic for about 3 weeks. She came to me after a couple months of dealing with paresis that improved with pred. When the RDVM decided to decrease her pred he condition deteriorated the state it is now. I'm dealing with money issues, so don't have as much imaging as I would like.

> > I finally talked them into getting neck x-rays. I'm not sure how to post these, but will keep trying. It appears to me there is compressive lesion maybe from trauma. This would go with the owner's story that this dog loves to chase cats and the cats will go thru a small hole in the fence or barn wall. So it's possible she could have run head-long into a wall.

> > Her first symptoms seemed to happen about a year ago and she recovered. Within the last couple of months the owner let her out of her cage. He said she tripped on the chain-link bar at the bottom of the door and and fell down. He said she's always been a dog who doesn't like help, so he turned and went on to do his chores. About 20 min later he noticed that she was still lying where she fell and that's when the pred treatment started.

> > I have done massage therapy, laser therapy, and some minor distractions on the neck. Since I've never done distractions I'm a little tentative. I've used NMES on the muscles of the left side because her right side seems to be doing better. I have the family doing flexor reflexes on all 4 legs, PROM and stretching, sitting her up over a peanut and doing cookies to each side. We also do standing therapy over the peanut. We've also been putting her in the UWTM twice weekly with 2 of us doing patterned walking with her.

> > I don't do acupuncture so it's not readily available when the owner bring her in for therapy. I've talked to the owners about beginning acupuncture with someone, but they are reluctant.>

> This is such a difficult case that I want all suggestions that anyone has. I have video of her in the UWTM also that I will try to post.> > I also feel that the dog is not trying. She is not food motivated, nor does she seem to be interested in moving. She can control her urine and waits for someone to take her outside in her Help-Em-Up Harness. When she is ready to urinate she will lift her rear legs up and apart and lift her tail to take care of business. When I pinch between her toes she will begin to withdraw and then kick backwards to get me to let go. Lately she does seem to kick as often or as hard, like she's just waiting for me to stop rather than put forth the effort to make me stop.

> > Any ideas would be greatly appreciated.> > Christie Carlo, DVM, CCRT>

[Guest guest]

Thanks for the reply . I did try some traction this week. I will try what

you suggest when I see her next week. The x-rays are posted under the Photos

link along the left margin of the VetRehab Yahoo page. I didn't know how to

include these with the message.

Christie Carlo, DVM, CCRT

>

> Hi Christie- Where did you post the xrays? I didn't see them. I just took

> Laurie's PT course. We did neck traction a number of different ways. One

> way was to have someone hold the shoulders and then the 2nd person pushes

> the head cranially holding right behind the skull, that might work- but if

> there really is a fracture, I might be worried too about the fracture moving

> and impacting the spinal cord. Could there have been some pathology in the

> bone before hand like multiple myeloma do you think? Or do you think it was

> all trauma?

> Hershey, DVM

>

[Guest guest]

Hi Christie, Sorry for my delayed reply. This Christmas-thing gets in the way of e-mailing to a certain extent!! I would do a one man traction in this case – less variables or margin of human error, and more likely that that dog will relax. I would select a side-lying traction as my first choice, but if she won’t lie in lateral recumbency willingly for you, then the sternal or over the knee/lap tractions would be my next favourites.I would just ensure that she is on a non-slip floor in order for her body weight to be the bracing of the body...and hence not requiring you to hold back her shoulders or anything. So for the side lying, position her appropriately (i.e. in side lying) and get her comfortable and trusting of you. Then position her neck in slight flexion (i.e. just to take out the naturally occurring lordotic curve in the neck – so that the entire spine is in a straight alignment). Use one hand with a thumb and finger (index or middle) behind her occiput – this is your pushing hand. The other hand can rest just under her chin (it will not push/pull etc...it is just there as support and a brace to disallow further neck flexion as you push on the skull. SLOWLY push to take up some of the slack in the neck and hold. Don’t go ‘as far as you can’. You want her compliance. Go slow, take up some slack, hold and as she relaxes, you might be able to take up some more slack. But remember, as I said in class, a) a little traction can go a long way & the dog has to relax with it in order to be effective. Hold the traction for 10 – 15 seconds (or longer...perhaps up to 2 minutes if YOU can tolerate it), and slowly release. Rest a few more seconds and repeat several times (maybe for a 5 – 10 minute session). All calm, slow, & gentle. If you are too fast, too strong, or not relaxed yourself, the dog with stiffen and reject the traction – perhaps extending the neck to ‘push you off’. Your job, as much as anything, is to ‘sell’ it to the dog by being slow, gentle, comforting, and calm.When YOU have the comfort level with it, I’d instruct the owners to do the same. You’ll have to get good at it, for the dog to relax and then the owners will see that the dog actually likes it – they are pretty clever at figuring out when something feels good. It’s magic with these guys!! Happy Christmas Eve! Laurie From: VetRehab [mailto:VetRehab ] On Behalf Of ChristieCSent: December-20-10 8:36 PMTo: VetRehab Subject: Re: Tetraplegic Dobe with neck compression Laurie - Please describe in detail how I should do traction for a caudal cervical lesion. Would it be better with 1 or 2 people? Would it be best with the dog lying on her side or sternal? Where is the best place to hold (back of skull, on the cranial neck, on the scapulas, mid-thorax)? How slowly and hold for how long? I gently tried this once and I could tell the owner was extremely nervous so I didn't do as much as I probably would have without the owner in the room.Thanks for your advise.Christie Carlo, DVM, CCRT>> Traction traction traction.> > You have to address the root of the problem before you'll have any success> in tackling the symptoms!> > J> > Laurie> > > > From: VetRehab [mailto:VetRehab ] On Behalf> Of ChristieC> Sent: December-19-10 8:12 PM> To: VetRehab > Subject: Tetraplegic Dobe with neck compression> > > > > > I have been working with a 7 yr old Dobe that is tetraplegic for about 3> weeks. She came to me after a couple months of dealing with paresis that> improved with pred. When the RDVM decided to decrease her pred he condition> deteriorated the state it is now. I'm dealing with money issues, so don't> have as much imaging as I would like.> > I finally talked them into getting neck x-rays. I'm not sure how to post> these, but will keep trying. It appears to me there is compressive lesion> maybe from trauma. This would go with the owner's story that this dog loves> to chase cats and the cats will go thru a small hole in the fence or barn> wall. So it's possible she could have run head-long into a wall.> > Her first symptoms seemed to happen about a year ago and she recovered.> Within the last couple of months the owner let her out of her cage. He said> she tripped on the chain-link bar at the bottom of the door and and fell> down. He said she's always been a dog who doesn't like help, so he turned> and went on to do his chores. About 20 min later he noticed that she was> still lying where she fell and that's when the pred treatment started.> > I have done massage therapy, laser therapy, and some minor distractions on> the neck. Since I've never done distractions I'm a little tentative. I've> used NMES on the muscles of the left side because her right side seems to be> doing better. I have the family doing flexor reflexes on all 4 legs, PROM> and stretching, sitting her up over a peanut and doing cookies to each side.> We also do standing therapy over the peanut. We've also been putting her in> the UWTM twice weekly with 2 of us doing patterned walking with her.> > I don't do acupuncture so it's not readily available when the owner bring> her in for therapy. I've talked to the owners about beginning acupuncture> with someone, but they are reluctant.> > This is such a difficult case that I want all suggestions that anyone has. I> have video of her in the UWTM also that I will try to post.> > I also feel that the dog is not trying. She is not food motivated, nor does> she seem to be interested in moving. She can control her urine and waits for> someone to take her outside in her Help-Em-Up Harness. When she is ready to> urinate she will lift her rear legs up and apart and lift her tail to take> care of business. When I pinch between her toes she will begin to withdraw> and then kick backwards to get me to let go. Lately she does seem to kick as> often or as hard, like she's just waiting for me to stop rather than put> forth the effort to make me stop.> > Any ideas would be greatly appreciated.> > Christie Carlo, DVM, CCRT> > > > > > __________ Information from ESET NOD32 Antivirus, version of virus signature> database 5716 (20101219) __________> > > > The message was checked by ESET NOD32 Antivirus.> > > > http://www.eset.com> __________ Information from ESET NOD32 Antivirus, version of virus signature database 5719 (20101220) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com __________ Information from ESET NOD32 Antivirus, version of virus signature database 5721 (20101221) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com __________ Information from ESET NOD32 Antivirus, version of virus signature database 5730 (20101224) __________ The message was checked by ESET NOD32 Antivirus. http://www.eset.com __________ Information from ESET NOD32 Antivirus, version of virus signature database 5730 (20101224) __________The message was checked by ESET NOD32 Antivirus.http://www.eset.com