Sciatic nerve impairment 3 weeks post FHO

[Guest guest]

Hi,

I am helping to rehab an approx. 3 year old 49# F/S dog that had an FHO on the

right hind about 3 weeks ago. She appears to have sciatic nerve damage now -

don't know what she was like post-op as she wasn't here. O's brought her in due

to her putting the top of her foot down on the floor. No superficial or deep

pain on the outer 3 digits (3,4,5) on the right hind, but does have sedation on

the medial digit (2). No cranial tibial response (ie no hock flexion, however

there is a muscle jerk prox. to the stifle when I do this). Good patellar

reflex. I am doing ROM, soft tissue massage, icing (since still feels warm to

me), PEMF, laser (6 joules/cm2), joint mobilizations and scratchfoot as well as

facilatory techniques like vibration on the toes. Started her back up on an

nsaid and am also doing estim on the quads/hams and the cranial tibial muscle

and gastrocs. She doesn't respond much when I do the estim on the cranial

tibial muscle - the intensity is set about about 3.5-4 on the quads/hams and she

becomes uncomfy, but have to turn up to about 6 or so before she even responds

and there is no 'vibration " of the muscle like there is on the quads/hams. Is

this due to denervation, or am I just not getting the leads on well enough?

width 200uS, rate 20hz, time 10min (was alternating).

I have discussed this situation with 2 surgeons and they both said that this

could have been a pre-op situation but I seem to recall this dog putting some

weight on the leg pre-op (sx elsewhere), and at least having pain there. I

realize that surgical manipulation in that area can cause neuropraxia, and I am

not trying to find fault with anyone just wanting to know what to expect/how to

treat most effectively. I have put a call into the surgeon that did the sx to

see if there was anything unexpected encountered during the sx or if she seemed

neurologically normal immediately post-op.

I took radiograhs here as I don't see that they were done post-op. There is a

little bone left above the lesser trochanter, but not enough that I feel that

this would be a significant issue - i don't feel crepitus.

Any other thoughts or recommendations?

Thanks!

Rob Tope, DVM, CCRT

[Guest guest]

I've been treating a dog with sciatic nerve damage post-op.  He  has progressively been getting better over the past year.  He is getting feeling back to his toes, but still knuckles over, so I got him a therapaw boot so that his foot can be planted properly and now he can run around like normal with the boot on. (He has the indoor and outdoor boot).  The dorsi-flex assist from Therapaw may also be helpful for you depending on how bad the dog is.  If the dog was walking on the leg without knuckling over before, then we know it is a surgical complication.  If the nerve was completely severed, then you don't have any hope of regaining function, but if the nerve was just stretched and damaged, then hopefuly he'll continue to get better.  

If the dog is painful, then that little bone spur that you see on x-ray may need to be filed off.  At home you could have the owner do 3-legged stands and standing on a bottom step.