On my first day back to work, I had two different dogs booked that morning – both with lumbosacral disc disease. Their trajectory along the therapy / healing process has been interesting, and really does highlight how care needs to be targeted to the dog in front of you and not the text book!
So, dog one is a German Shepherd. A lovely intact male with a very dedicated owner. He bounces between myself and another clinic therapist. Along the way we have treated his lumbosacral region with manual therapies (to the lumbar spine, sacroiliac joints, and anywhere else needing attention) – mobilizations, craniosacral, dural glides, and some myofascial techniques. He gets laser, radial shockwave, acupuncture and all treatments occur on the PEMF mat. Additionally, the owner has been shown how to do some exercises designed to target core stability (i.e. abdominal strengthening).
He's had some ups and downs, but overall, he has been managed without need for injections or surgery. The owner is overall happy that he has been managed conservatively.
The second dog is a Rottweiler. She’s funny in that I’m in her ‘inner circle’ of people, but I’ll still get the grumble and Rottie ‘side eye’ now and then. This girlie on the other hand has had more issues of crying with getting up and down from lying, and her trajectory of healing has been a bit of a roller coaster. Her treatment is primarily shockwave, acupuncture, mobilizations, PEMF, because when she comes in, she’s usually more flared up. For this owner-dog combo, I put them in touch with a vet surgeon that has done cortisone injections for her. So, she has had 3 rounds of 3 ‘month-apart injections’… and for her, they last her about a year and a half each time.
These owners are happy that they have a ‘fix it better’ strategy for when the rehab can’t manage their dog’s pain. Now, only in writing this, do I think… gee I could be doing more with the Rottie. But on the other hand, I think the Rottie needs the extra ‘injection help’, and overall is a bit more sore and requiring more of a pharmaceutical intervention.
Where am I going with these two stories?
Well, here are my epiphanies that I think are worth sharing.
- Both dogs are being successfully managed. I am not failing the Rottie because she’s on medications and needs a periodic injection. I have helped to get that dog to the right veterinarian to help them with that issue, and I am the ‘maintenance person’ between times. I’ve encouraged home maintenance strategies, and the owner bring this dog when she’s flared up. That’s a win.
- The German Shepherd we have managed to keep away from the meds and injections. He is able to be very active. He gets routine treatments / preventative therapies. That’s a win.
- It’s okay to treat differently depending upon the case – even if the ‘diagnosis’ is the same. That’s the ‘art’ of healthcare!
- Both of these dogs need maintenance physio / rehab, and both of these owners need encouragement, options, education, and advisement.
So, I guess the morale of the story is to be okay with the variety of approaches to treat a case. Celebrate them! Be open minded & adapt as need be.
And have a great week ahead!