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Hi Laurie,

I have a difficult case!!

For 1 month I've been treating an 8 yr old german shepherd after a surgery for multiple disc protrusions: T13-L1 , L2-L3, L4-L5. Before surgery, he had reduced propioception on his left rear leg.

After surgery he was paraplegic with deep pain preserved, but no bladder function.  Motor function of his right rear came back almost immediately, bladder function returned after 3 weeks. Left rear regained motor function 2 weeks ago but he still has no strength: he tries to stand up, makes some steps, but suddenly crosses the legs (right one- the strongest- goes towards the left one, so he falls down).

We are doing acupuncture, flexor reflex stimulation, NMES over thigh muscles for muscle atrophy, laser over ileopsoas muscles (during last days he showed pain in that area with a bunched back), assisted sit to stands, ball work, assisted cavaletti (only one or two), assisted walking and UWTM.

The question is, assuming that the surgery had a good result, how much time is necessary for a complete recovery in this kind of chronic cases (the deficit was old)? Can I do something more to improve strength and coordination? 

Thank you and cheers....

M.S.

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Hi M,

It sounds like it was not good that they did surgery on this dog!  Not everything is fixable with surgery.  

You are doing all the right things.  The only other things I would suggest would be 'patterning'.  (i.e. training patterned walking when on a treadmill - land or UWT… with you moving the affected limb or providing a little bit of resistance to get the right movements to occur).  Working on a treadmill works better than following the dog around when he's walking himself.  You control the speed and direction that way.  The more of this you can do the better!  As he gets walking then you can challenge his balance with quick pushes on his rump or sustained pressures so that he has to work against it… this will build coordination.  You need forward motion and strength, before you can ask for coordination… and it sounds like he still needs the strength component.

I would only do the NMES if it were in conjunction with standing and weight shifting.  For the neuro dogs… all exercises need to be functional.

Might as well do the flexor withdrawal stimulation in standing as well.  If he is weak in standing, then do it with him over a ball or stool… for the same reason as above:  making it functional.

The key to neuro is repetition, repetition, repetition.  The body needs to 'rewire' in the spinal cord again and it will take lots and lots of practice to rewire properly.

I hope this helps!

Cheers,

Laurie