Piki - 12 Year Old with Osteoarthritis of Hips and Elbows

Reason for Referral:
Geriatric dog with osteoarthritis of hips and elbows. Bilateral hip dysplasia diagnosed as 7 year old.

Medical history:
October 2003: Given Cartrophen injections 4 weekly then annual top ups. This helped initially.

November 2005: Worsening of symptoms and reluctance to walk. Prescribed Rimadyl (non-steriodal anti-inflammatory) and Seraquin (neutraceutical joint supplement), which did improve her mobility, although she still struggled in cold/damp weather.

November 2006: Progressive worsening of mobility and reluctance to walk. Dog very dull and depressed, especially in cold and damp conditions.

Veterinary examination:
Generalised osteoarthritis and severe pain and reduced ROM bilateral hips and elbows. Piki was very uncomfortable and generally restless.
Moderate to severe muscle atrophy of gluteals, hamstrings and quadriceps, and hindlimb weakness generally. Difficulty sit-stand and owners report dog reluctant to rise without assistance. Very stiff and stilted action as lame forelimbs and hindlimbs. Acupuncture point SP12 reactive which may indicate sciatic pain L>R. Acupuncture performed bilateral, local elbow points LI11,TH10, LU5 and bilateral hip points BL54, GB20/30. Also BL23, BL40, BL60, ST36/SP6, lumbar Ba Hui.

30/11/06 - Much improved and owners reported Piki “bounding around like a 2yo!”
Dog much happier and very much improved mobility-excellent response after only 24 hours post acupuncture treatment. Repeat acupuncture using similar points repeat acupuncture 1 week.

4/1/06 - Acupuncture repeated using same points and dog wanting to go for walks at home and demeanour much more like she used to be.

9/1/07 - Begin bi-weekly aquatic treadmill sessions to strengthen hindlimb muscles and improve joint ROM in elbows and hips. Initially 2min warm up then 2x 3mins, 2 min warm down and coped very well.

Bi-weekly treadmill for 4 weeks and excellent improvement in muscle strength and cardiovascular fitness.
Discussion with referring vet. Reduced Rimadyl dose to half, and maintain on joint supplement.

Plan:
Reduce treadmill to once weekly for 3-4 weeks then owner very keen to carry on with 2 weekly maintenance sessions as there has been such an improvement in Piki’s willingness and ability to exercise.

Acupuncture sessions 4-6 weekly to maintain relief from chronic pain.

Progressive home exercise programme with small frequent walks 4-6 x daily.