CHESTER
Chester is a 9 year old black labrador who had an acute episode of tetraparesis (off all 4 legs), after a disc rupture in his neck, on the 26th June 2009. An MRI scan showed that there was a disc injured and associated haemorrhage at the base of his neck (C5-6 worse on the left side). He needed immediate surgery to decompress the spinal cord, and at the time it was advised that he would need further preventative surgery. This was because several other discs in his neck were degenerate, and this increased chance of this happening again.
Assessment: Chester was referred to Linhay on the 6th July 2009, as his owners felt they could not mange him at home, due to the degree of disability, as well as the problem with likely recurrence with one of the other discs. He was able to sit up by that stage and had voluntary movement in all four limbs, but was unable to stand without assistance. He had reduced neurological function (very slow reflexes), and knuckled on all four limbs. He also had the complication of having hip dysplasia and osteoarthritis.
Treatment: After increasing Chester’s pain relief using acupuncture, we were able to begin an intensive 3 week rehabilitation programme, where we effectively taught Chester to walk again. He was fitted with a special harness and we started work on our hydrotherapy treadmill, as well as other therapeutic exercises, to improve his ability to place his limbs and build strength. He improved on a daily basis and was discharged from Linhay on 23/7/09. His ongoing care was then carried on by another ACPAT physiotherapist closer to his home where he was seen as an outpatient.
Follow-up: Chester had recovered sufficiently to have his second lot of surgery on 15th September 2009. This was a ventral slot (fenestration of discs with an approach from under the neck) where the degenerate discs were removed. This prevents further disc problems occurring in the neck. He did well post operatively, but the owners felt that the specialist care he could receive at Linhay would be ideal to maximize his recovery. He was re admitted for further rehabilitation, including acupuncture and physiotherapy, both in the hydrotherapy treadmill, as well as with land based exercises. Chester progressed very well, and was discharged on October the 20th 2009.
His owners will continue at home with a controlled exercise programme, under the supervision of their own Chartered physiotherapist, and with our advice and ongoing support as required.
Wednesday 23 December 2009
Tuesday 22 December 2009
Charlie - TB retired chaser/point-to point gelding
Charlie is a 12 yr old TB ex chaser/point-to-point gelding. He was purchased in the summer 2009 for hacking and riding club activities. After a few months his owner notice that he had started to become argumentative in accepting the contact when ridden, he also appeared intermittently lame on both FL's and right the HL especially on a right circle.
Charlie was worked up by equine vet Richard Stringer who rasped his teeth and took x-rays of his front feet. He then liased with farrier Graham Tully who gave Charlie more heel support both in front and behind. Charlie also had a new saddle fitted and received several acupuncture sessions with vets Wendy Vere and Kate Rew.
Physiotherapy Treatment: Helen Mathie and Louise Towl, Chartered Physiotherapists, treated Charlie regulary over a 4 week period which included:
Soft-tissue release to bilateral scapulo-thoracic and thoraco-lumbar epaxial muscuature; laser cluster following soft-tissue release to epaxials; Biomag to TMJ (bilateral) and masseter muscles; baited cervical side flexion stretches as daily exercise programme. In addition Helen rode Charlie twice weekly in a low outline to encourage stretching through the topline and back musculature.
He was reviewed by Richard mid-December 2009 who felt that Charlie was less sore through his poll, neck and back and was now sound in front and behind. The plan is to continue weekly physiotherapy treatments as required as well as twice weekly remedial schooling. In addition his owner is to ride Charlie out hacking and aims to complete a dressage test at Bicton in January 2010!
Charlie was worked up by equine vet Richard Stringer who rasped his teeth and took x-rays of his front feet. He then liased with farrier Graham Tully who gave Charlie more heel support both in front and behind. Charlie also had a new saddle fitted and received several acupuncture sessions with vets Wendy Vere and Kate Rew.
Physiotherapy Treatment: Helen Mathie and Louise Towl, Chartered Physiotherapists, treated Charlie regulary over a 4 week period which included:
Soft-tissue release to bilateral scapulo-thoracic and thoraco-lumbar epaxial muscuature; laser cluster following soft-tissue release to epaxials; Biomag to TMJ (bilateral) and masseter muscles; baited cervical side flexion stretches as daily exercise programme. In addition Helen rode Charlie twice weekly in a low outline to encourage stretching through the topline and back musculature.
He was reviewed by Richard mid-December 2009 who felt that Charlie was less sore through his poll, neck and back and was now sound in front and behind. The plan is to continue weekly physiotherapy treatments as required as well as twice weekly remedial schooling. In addition his owner is to ride Charlie out hacking and aims to complete a dressage test at Bicton in January 2010!
Austin - 9 yr old male labrador with C5/6 spinal cord compression
Austin was a rescue labrador who started to develop neurological signs with intermittent episodes of acute neck pain in June 2009. He collapsed one day and was sent immediately by his referring vet to orthopaedic surgeon Damien Bush. C5/6 decompression surgery via a ventral slot approach was perfomed and once stable Damien referred Austin down to Linhay to start his rehabilitation.
Assessment - Austin arrived at Linhay on bonfire night very quiet and unable to stand/walk. He was laterally recumbant and could just about manage to wag his tail and lift his tail albeit briefly. He was assessed by vets Patrick Ridge & Wendy Vere, alongside Chartered Physiotherapist Louise Towl. He had deep pain sensation in all four limbs but very weak withdrawal reflexes. FL/HL reflexes were present in all 4 limbs but Austin initally had diffculties emptying his bladder independently.
Treatment - Austin remained on Vetagesic initally to help manage his post-operative pain, he was also on Metacam daily. Wendy performed several acupuncture sessions to further assist with pain relief. He required frequent postural changes alternating between right and left side-lying as well as supported sternal recumbancy to enable him to interact with his environment. He needed assistance to eat and drink as he wasn't able to maintain an appropriate head and neck position at first. He was fitted with a spinal harness for all physiotherapy sessions to ensure his neck comfort an safety. In addition Austin was stretchered outside for toileting during the first two weeks.
Austin was worked daily over a physio 'peanut roll' in both functional sitting and standing positions. In addition he was positioned in side lying for soft-tissue/joint ROM sessions. At the end of week two Austin attempted to stand and was then progressed onto the hydrotherapy treadmill with the physiotherapist supporting him. He initally needed help with positioning his FL/HL's and maximal trunk support via a sling and theraband system. From that moment on he seemed to suddenly turn a corner and began to progress rapidly on a daily basis. By the end of week three Austin was walking outside for toileting with moderate support from a spinal harness.
He was discharged home after four weeks of intensive rehabilitation to his owners who had been visiting Linhay on a weekly basis. Helen visited Austin at his home last week and is pleased to report that he has progressed even further thanks to his owners input. He is now independently ambulant around the house and garden and is back to his cheerful self.
It must be stressed how cases like this can take weeks to improve and need a significant amount of appropriate, timely physiotherapeutic and nursing input. Owner commitment and compliance on discharge is paramount for successful outcome and not all cases will return to the same level of function.
Assessment - Austin arrived at Linhay on bonfire night very quiet and unable to stand/walk. He was laterally recumbant and could just about manage to wag his tail and lift his tail albeit briefly. He was assessed by vets Patrick Ridge & Wendy Vere, alongside Chartered Physiotherapist Louise Towl. He had deep pain sensation in all four limbs but very weak withdrawal reflexes. FL/HL reflexes were present in all 4 limbs but Austin initally had diffculties emptying his bladder independently.
Treatment - Austin remained on Vetagesic initally to help manage his post-operative pain, he was also on Metacam daily. Wendy performed several acupuncture sessions to further assist with pain relief. He required frequent postural changes alternating between right and left side-lying as well as supported sternal recumbancy to enable him to interact with his environment. He needed assistance to eat and drink as he wasn't able to maintain an appropriate head and neck position at first. He was fitted with a spinal harness for all physiotherapy sessions to ensure his neck comfort an safety. In addition Austin was stretchered outside for toileting during the first two weeks.
Austin was worked daily over a physio 'peanut roll' in both functional sitting and standing positions. In addition he was positioned in side lying for soft-tissue/joint ROM sessions. At the end of week two Austin attempted to stand and was then progressed onto the hydrotherapy treadmill with the physiotherapist supporting him. He initally needed help with positioning his FL/HL's and maximal trunk support via a sling and theraband system. From that moment on he seemed to suddenly turn a corner and began to progress rapidly on a daily basis. By the end of week three Austin was walking outside for toileting with moderate support from a spinal harness.
He was discharged home after four weeks of intensive rehabilitation to his owners who had been visiting Linhay on a weekly basis. Helen visited Austin at his home last week and is pleased to report that he has progressed even further thanks to his owners input. He is now independently ambulant around the house and garden and is back to his cheerful self.
It must be stressed how cases like this can take weeks to improve and need a significant amount of appropriate, timely physiotherapeutic and nursing input. Owner commitment and compliance on discharge is paramount for successful outcome and not all cases will return to the same level of function.
Molly - 2yr old whippet bitch with cervical fracture
Molly is a 2 yr old whippet bitch who sustained a C3-4 vertebral end-plate fracture with associated spinal cord and epaxial muscle bruising. This happened during a rotational fall whilst out being exercised at the end of September 2009. She was referred to Linhay for spinal rehabilitation by orthopaedic surgeon Damien Bush.
Molly did not have any surgery following her accident as the fracture was deemed to be stable. However we had to ensure that she was positioned and handled correctly at all times to ensure her comfort and safety during her rehabilitation.
Assessment - Molly was assessed by vet Kate Rew and Chartered Physiotherapist Helen Mathie. Although Molly was bright and alert on arrival she was laterally recumbant favouring left side lying. She demonstrated increased tone through the right side of her trunk, right forelimb and right hindlimb. She was not able to stand without assistance and knuckled over onto the dorsum of the right fore and hindlimbs respectively. Reflexes were present in all four limbs but were brisk in the right FL/HL, withdrawal response was present in all 4 limbs. There were no signs of cranial nerve involvement. Due to the increased tone in the right side of Molly's body she was quite uncomfortable through her neck muscles.
Treatment - Molly was on Metacam for pain relief however we felt that she would also benefit from acupuncture to address in particular her neck discomfort. In addition part of her daily regime consisted of frequent postural changes (alternating right and left side lying with supported sternal recumbancy) to help prevent secondary soft-tissue shortening as a result of her altered tone. Daily physiotherapy included gentle passive joint ROM, soft-tissue mobilisation and facilitated standing/balance work in a spinal harness. She didn't get on well with the physio 'peanut ball' so was worked in a more functional supported standing position instead. During all Molly's physiotherapy treatments she was handled and positioned in such a manner as not to increase her tone by giving her a large base of support. She was a cheerful little soul but as with many neurological cases had a tendancy to fatigue quickly, therefore treatment sessions were 'little and often'.
Molly was fitted with a lightweight neoprene carpal splint to help prevent the right FL knuckling however due to proximal muscle weakness in her right shoulder girdle she found it difficult to initiate movement against gravity, let alone move the limb with the added weight of a splint! However over a period of 4 weeks Molly progressed to further proprioceptive and stengthening work in the hydrotherapy treadmill. Throughout all her hydrotherapy treadmill sessions Molly needed to be assisted by the physiotherapist in relation to the the right FL/HL placement. The treadmill was favoured instead of the pool as the sensation of Molly's pads on the treadmill belt helped to stimulate a normal gait pattern but within a buoyant environment that assisted her weak muscles.
Molly was discharged home to her dedicated owner after four weeks of intensive rehabilitation. She is now independent around the house and has frequent physiotherapy sessions as a outpatient with another Chartered physiotherapist closer to her home.
Molly did not have any surgery following her accident as the fracture was deemed to be stable. However we had to ensure that she was positioned and handled correctly at all times to ensure her comfort and safety during her rehabilitation.
Assessment - Molly was assessed by vet Kate Rew and Chartered Physiotherapist Helen Mathie. Although Molly was bright and alert on arrival she was laterally recumbant favouring left side lying. She demonstrated increased tone through the right side of her trunk, right forelimb and right hindlimb. She was not able to stand without assistance and knuckled over onto the dorsum of the right fore and hindlimbs respectively. Reflexes were present in all four limbs but were brisk in the right FL/HL, withdrawal response was present in all 4 limbs. There were no signs of cranial nerve involvement. Due to the increased tone in the right side of Molly's body she was quite uncomfortable through her neck muscles.
Treatment - Molly was on Metacam for pain relief however we felt that she would also benefit from acupuncture to address in particular her neck discomfort. In addition part of her daily regime consisted of frequent postural changes (alternating right and left side lying with supported sternal recumbancy) to help prevent secondary soft-tissue shortening as a result of her altered tone. Daily physiotherapy included gentle passive joint ROM, soft-tissue mobilisation and facilitated standing/balance work in a spinal harness. She didn't get on well with the physio 'peanut ball' so was worked in a more functional supported standing position instead. During all Molly's physiotherapy treatments she was handled and positioned in such a manner as not to increase her tone by giving her a large base of support. She was a cheerful little soul but as with many neurological cases had a tendancy to fatigue quickly, therefore treatment sessions were 'little and often'.
Molly was fitted with a lightweight neoprene carpal splint to help prevent the right FL knuckling however due to proximal muscle weakness in her right shoulder girdle she found it difficult to initiate movement against gravity, let alone move the limb with the added weight of a splint! However over a period of 4 weeks Molly progressed to further proprioceptive and stengthening work in the hydrotherapy treadmill. Throughout all her hydrotherapy treadmill sessions Molly needed to be assisted by the physiotherapist in relation to the the right FL/HL placement. The treadmill was favoured instead of the pool as the sensation of Molly's pads on the treadmill belt helped to stimulate a normal gait pattern but within a buoyant environment that assisted her weak muscles.
Molly was discharged home to her dedicated owner after four weeks of intensive rehabilitation. She is now independent around the house and has frequent physiotherapy sessions as a outpatient with another Chartered physiotherapist closer to her home.
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