This blog is just a wee update on the Crazy Cases I have seen of late. For those of you just tuning in, these cases were discussed in previous blogs:
https://www.fourleg.com/Blog?b=537 This was part 1 and included the Australian Shepherd with the head tilt, as well as the Doodle with the jammed-up hip and pelvis.
https://www.fourleg.com/Blog?b=538 This blog was part 2 and included the tiny Maltese X with severe carpal laxity and my sister-in-law’s little Mexican rescue with a shoulder lameness.
I received a few emails asking for updates on these cases, so I thought I’d put it all into another blog.
Case 1: The Australian Shepherd with the head tilt subsequent to a cancer in the middle ear.
About a month prior the other therapist working with the case had sent a letter back to the dog’s family vet to query a deep inner ear infection. She was told “no infection”.
Fast forward a month and a CT later, the radiologist figured something looked off and put forth the possibility of a deep inner ear infection. So, the dog is on a long course of antibiotics to see if it helps.
When I saw him last week, his balance was better but the head tilt has persisted. The area over the ear is less ‘warm to the touch’ but his mastoid process is still very tender. I most recently added acupuncture, laser, craniosacral, and Atlanto-Occipital joint mobilizations (without touching the mastoid process). We’ll see how it goes!
Case 2: The Doodle that fell off the bed who we suspect to have a labrum tear at the hip. I saw this case again just this week. The pelvis is in a better static position and motion at that joint seems improved, but there is still pain with hip flexion, and gait is compromised – with circumduction of the hip and a ‘lateral hike / side flexion’ of the affected pelvis in order swing the affected leg forwards.
This case frustrates me… as I was hoping for more changes at the hip. She’s received hip and SIJ mobilizations, shockwave, and laser therapy as well as massage. When I last saw her, I tried some hip mobilizations in distraction (which were still painful), so on a whim, I tried compressions, which she tolerated well. We’ll see what that brings.
The owner is not interested in a surgical consult, and x-rays do not show anything suspicious. So, we’re still thinking it’s a labrum tear and wondering how best to address this conservatively.
Case 3: The tiny Maltese cross with severe carpal laxity. Here, I am kicking myself for not taking ‘before pictures’. So, I used my ‘Junior High Home Economics’ skills and sewed him some little braces. They were tiny!!! However, without any extra reinforcements other than the neoprene and Velcro strips, they did great and the little one was happy to walk around in them!
Hopefully that will do the trick!
Case 4: My sister-in-law’s Mexican rescue Chihuahua mix with the medial shoulder hypermobility. After the treatment given, restrictions reinstated, and providing information on hobbles… the report came back about a week later that after she had seen me, the lameness just went away. So, they didn’t look into the hobbles further, and haven’t done anything more. I’m sure I’ll get an update during the holidays!
So, those were and are some of my most challenging cases of late! #Clinical Reasoning
Until next time… Cheers!