Laurie's Blogs.

Good Morning Laurie!

I hear ya on the yoga doing more harm than good. I wish I could reap the mental rewards and preserve my out of shape muscles!  

I appreciate the ability to ask questions so here goes;

I am an LVT pending rehab certification (test in 2 weeks-yikes).  One of my patients is a 92# (not too overweight) golden retriever that is 4 weeks out from a TPLO repair. He became acutely lame on repaired leg and arthocentesis showed septic infection. We are 5 days past that and yesterday he completely tore his other cruciate ligament. At my disposal, I have a therapeutic laser, my hands, and the intention to help him heal. We are prescribing tramadol, nsaid, gluc/chond, antibiotics.  He is only portable by sling and harness right now.  Other than the laser, massage and range of motion on the new tear, do you have any advice?  

Thanks again for being such a great source of information.  I have a sneaky suspicion you are not aware how much your website empowers people to grow!

M.C.

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Hi M.C.,

Sorry for my tardy reply.  I have been so behind over the last few months!  But today I vow to answer at least 20 e-mails... So here we go!

Firstly, thanks for commiserating about the yoga!  I have not been to class now for a couple of weeks and I might be slowing 'glueing' back together!

And now as for your patient....

Since surgery is not high on the list right now while his other leg has an infection... you will have the opportunity to rehab the second tear with conservative measures.  (Even if surgery is to be contemplated on down the road... let's just pretend that it all relies on YOU being the hero!!)

So, you need to get him using the legs as soon as possible and as often as possible!  Both of them!

Get him up as often as you can.  Either over a peanut ball or stool, or your knee/thigh... whatever.  Just get him up!  You cannot make any appreciable gains in muscle with an animal in a downed state (not with e-stim, not with toe pulls / tickles, not with ROM, Massage, etc).  You have to get him up!!!  (Three exclamation marks = very important!)  

His front are good... so if you and another are able to walk him in harness for 5 - 10 minutes... then do so!  The attempt to walk and circulation alone will be helpful.

When upright (ideally supported so that he is responsible for his own weight and you can work on the rears), then use your e-stim on the quads along with weight shifting.  If you don't have an e-stim, then just work on weight shifting and rhythmical 'bouncing' on his rear end (i.e. push down on his rear end, while his legs are propped into a proper stand.  This will facilitate muscle contractions and extension in particular via activation of the muscle spindles & golgi tendon organs.) 

Any standing practice will be useful.  Even if he doesn't move.  As he seems to strengthen in his rear legs, then try to elevate his front feet or lift one front leg off the ground.  (Keep an arm under him incase his legs give out.)

You could also try pinching a toe on one foot at a time to stimulate a stepping response while in standing.

Once the infection is cleared (or well on it's way to clearing), and the acuity has subsided in the newly torn leg, then you can just go about rehabbing him like a normal post-op and incorporate some more advanced strengthening... (check out the video & article on conservative management of cruciate deficiency).

Good luck!  It's do-able, but very labour intensive in the first couple of weeks in the case of a bilateral issue.  (A brace might help… but you're waiting a few weeks to see it come back to you anyways… so try theses things to begins with anyways.)

And thank you for your kind words about the website. 

Cheers!

Laurie