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.
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