14 week old bulldog with hemivertabrae

December 28, 2011

Good morning

I saw a puppy today that at 8 weeks of age came back in from the yard unable to

use his back legs. He was not evaluated at that time by a DVM, but instead the

owner built him a cart and he's been dragging his legs around since. He is now

14 weeeks old and has a new home. The owner is interested in whatever we can do

to get him functioning.

Radiographs reveal either hemivertabrae at L1-L2, or trauma, or a combination of

both. It is difficult with the age of the pup and the amount of time from the

initial incident to unravel how much is new bone formation from trauma, or how

much is congenital deformity.

On exam he is bright and alert, normal reflexes, CP, motor and pain on the front

legs. Kyphotic deformity in the T-L junction as well as an s-curvature

laterally. He is not painful on palpation of the spinous processes. He has

bilateral laxity of the hips and positive ortalani. CP deficits bilaterally,

what I would consider to be normal reflexes, postitive withdrawal and pain

sensation bilaterally on a toe pinch, voluntary motor, but ataxic and weak. He

has laxity of the tarsal flexors and both of his tarsi are hyperextended, as are

his stifles which I interpret from his limb position while in the cart as he was

dragging his hind legs with full contact of the dorsum on both sides.

I am able to get him to a square sit and hold him there. When released he is

able to rise to standing and start forward movement, but his lack of

proprioception prevents him from maintaining normal postion of the feet for more

than 1 or 2 steps.

I have the owners doing passive ROM exercises on both hind legs using pressure

on the pads to simulate floor contact and normal flexed position of the hock and

stifle and have them following that with toe pinches to stimulate active

withdrawal. I also have them doing assisted square sitting and holding him in

that position for a few seconds, then allowing him to rise to standing, as well

as supported standing with feet flat.

Any other thoughts. I'm due to see him again next week and hope to phase out

the passive ROM to more active ROM and HOPE that we are starting to see some

tightening of his tendon laxity and improvement in his hyperextension. Once

there I want to work on his proprioception....ideas?? Am I on the right track?

Other things I should do?

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