Laurie's Blogs.

Laurie,

A staff member at work has a dog that has gracilis myopathy.  I have been looking through my notes from class, and my books, and have not been able to find anything definitive for treatment other than to say that rehab works the best.  I have seen recommendations for therapeutic US and stretching.  I have also read about home exercises, but have not seen any suggestions on the exercises to recommend. 

I do not have a therapeutic US.  I was wondering if laser may be helpful.  I was also wondering if I want to try to strengthen the gracilis, semimembranosus and semitendinosus?  Any other suggestions for rehab treatment? 

Thanks,

LW

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Hi L,

These are just sad cases.  I don't find that you can every really 'fix' them.  You could maybe improve things a little... but not 'fix'.  Sometimes we just need to try a little so that the owner can accept the dog for what it is now.

So the thought behind ultrasound is that you can heat the fibrotic tissue before trying to stretch it. From that premise - why not try laser, massage, dry needling and/or a hot back prior to stretching. Hair impedes the ultrasound energy so it could have limited application in a long haired dog - unless you were to trim the hair.  I had one case that was trauma induced.  I stretched the tar out of it and it improved - resolved even.  My only successful fibrotic myopathy case!  The others have all been problematic.

You can try to strengthen whatever you like in that leg... but from a functional perspective.  The contracture is fibrous tissue - so strengthening the leg doesn't make that tissue stronger or weaker.

I would look at these cases as needing overall conditioning, prevention or management of secondary issues due to the postural adaptations in the spine,  and a trial of stretching to see if you might have one of the ones that will resolve with it... While you might not be stretching out the fibrosis / contracture itself, there is the chance that you could be stretching out the tissues around the fibrosis that are still extensible and could give rise to greater lengthening.

Stretch for at least 30 seconds or more, x 3 reps, 2 x / day as your at home recommendation.  In clinic - you could try a few of the more aggressive stretches (once the owner has bought into YOU... otherwise you'll lose them if you do it on day one!!)

I'm afraid that I don't have a magical-elixir-cure for these guys!

Laurie