Laurie's Blogs.

Good Morning Laurie,

Have you ever treated a neuro patient (dog) who kicks frequently with one of its back legs?  We currently are caring for a Wheaton Terrier who had a right sided hemilaminectomy at L2-3 with fenestration of L2-3 and L1-2 this past August and although she continues to get stronger she does this strange kicking of her right hind when she's standing.  It's almost like she's trying to start up a dirt bike or something.  Some days it's worse than others and she also chews on her feet, more the right hind.  She is an allergy dog and one of our doctors started her on Hydroxyzine and she's been on Gabapentin since surgery.  She also has DDD of T13-L5 and L7-S1...poor girl.  We have been utilizing laser therapy, core strength, proprioceptive, and generalized strengthening exercises; as well as Acupuncture on a weekly basis but can't get her to use the right hind consistently and stop kicking the leg.  We have underwater treadmill and tried her in it, but she panics and refuses to walk.  She's rather strong willed and her leg usage greatly improves when she's able to decide when and where she wants to walk.  we absolutely LOVE this girl and want to see her continue to improve.  Do you have any suggestions?  Oh and she's a very skittish girl.

Thank you so much, I really appreciate your time and expertise.

HH

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Hi H,

Interestingly, I was just talking about this sort of thing with someone just recently.

So, I think that some of the kicking could either be coming as a reflex loop - i.e. something sets off the reflex (could be a random active muscle firing) and then the reflex loop kicks in to create the kicking.  My other thought is that it is the result of misfiring at the site of the spinal cord lesion... and this is what is getting through as the messaging without the proper 'dampening' of the movement by the active control of the brain.

Either way, I would add some things to the rehab.

1) traction.  Help the back and spinal cord environment to heal  (see the video on traction techniques).  This size of dog would likely do okay with hanging traction even, and it would be the easiest to administer / prescribe.

2) limb placement practice... either in the UWT with the dog - you placing the leg for her, or on a slow moving land treadmill.  I like both of these options better than trying to crawl around behind her and having her move on the ground to get  a treat.  But if that is what you have to do, then just try to make sure that she's going slowly.

3) Try the e-stim stepping practice in standing (if she's not too skittish).  (Watch the E-stim tricks video)  Essentially put one electrode under her foot, and the other on her leg, hip, or back.  Then when is comes on, she has a flexor withdrawal on that side and a crossed extensor on the other side.  If you have a machine that alternates, then you can set up the other foot to be just like this, and you can create the stepping reaction in standing.  If your machine doesn't alternate, then just do one at a time - about 7 minutes each side.  If she is too scared of the e-stim then try to do with with just a finger in the foot pads - to get a flexor withdrawal, one side at a time.  The only way to get rid of adverse reactions is to 'practice it away'... repeat, repeat, repeat for motor learning / relearning.

4) And alternately, you may want to play around with using theraband looped to a harness, or a weight, or a booties on that leg, or any sort of gadgetry to change the input / output.  With this, you don't really know what you'll get until you start to try things.

Best of luck!

Laurie