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Hey fellow animal health pros—if you've ever faced the tough prognosis of a paraplegic dog with a thoracolumbar spinal cord injury and no pain perception, this study might just brighten your day. Published in the Journal of Veterinary Internal Medicine back in 2017, researchers from the University of Bologna and a rehab center in Italy took a deep dive into whether intensive physiotherapy could help these pups regain involuntary locomotion, known as "spinal walking" (SW). Spoiler: The results are encouraging!

The Setup: What They Studied

The team retrospectively reviewed records from 81 dogs—all acute cases of paraplegia due to intervertebral disk extrusion (IVDE) or trauma, confirmed by MRI or CT, and crucially, with no pelvic limb pain perception throughout treatment. These are the tough ones we all know have a historically poor shot at voluntary recovery. The dogs underwent a tailored rehab program including passive range-of-motion exercises, reflex stimulation, assisted activities, electrostimulation (if needed), and hydrotherapy on an underwater treadmill. Sessions were daily, twice a day, lasting about an hour each.

The goal? To see how many could develop SW—an unassisted, reflex-based gait powered by the spinal cord's central pattern generator (CPG), without brain input. They also crunched numbers on factors like age, weight, lesion type/site, and rehab timing to spot what influences success.

Key Findings: Hope for the Hopeless?

Out of the 81 dogs, a solid 59% (48 pups) achieved autonomous SW, meaning they could walk indefinitely on their own and even stand back up after falling. The median time to get there? About 75.5 days, ranging from 16 to 350 days. That's a game-changer compared to older studies where only around 11% of similar cases regained any walking ability without targeted rehab.

What boosted the odds?

•    Younger dogs: Those 60 months (5 years) or under were more likely to succeed (P = .012 in multivariate analysis).

•    Lighter weights: Dogs ≤7.8 kg had a big edge (P < .001), though even one 26 kg heavyweight pulled it off.

Factors that didn't matter much? Body condition score, full-time hospitalization vs. day-hospital, lesion type (IVDE vs. trauma), or exact site (from Th4-Th5 to L2-L3). Interestingly, even some lesions at the presumed CPG level (L2-L3) led to SW, challenging old assumptions.

Early rehab start showed promise in initial stats but didn't hold up in deeper analysis. Still, the overall high success rate hints that intensive therapy—like underwater treadmill work—might be key in kickstarting those spinal reflexes.

Deep Dive Into Core Exercise Categories

The protocol incorporated five basic categories of exercises, arranged differently based on individual dog requirements:

•    Passive Range of Motion (ROM) Exercises: Manual manipulation to maintain joint flexibility and prevent contractures in the pelvic limbs.

•    Flexor Reflex and Crossed Extensor Reflex Stimulation: Targeted sensory stimulation to elicit and reinforce reflex responses, aiding in the activation of spinal circuits.

•    Active Assisted Exercises: Guided movements where the dog was supported to perform partial weight-bearing or stepping actions, promoting muscle engagement.

•    Electrostimulation: Applied only in cases of post-spinal shock hypotonia (low muscle tone); used to stimulate muscle contractions and improve tone.

•    Hydrotherapy on Underwater Treadmill (UWTM): Buoyancy-assisted walking in water to reduce weight load while encouraging limb movement. Specifics include:

            Started upon admission (or at least 5 days post-surgery for surgical cases).

            Initial speed: 1.8 km/h.

            Initial bout duration: 5 minutes, progressively increased to up to 15 minutes once pelvic limb movements were observed.

Frequency and Duration

•    Session Length: Approximately 60 minutes per session.

•    Frequency: Performed every day, twice per day, for all dogs—regardless of hospitalization status (full-time or day-hospital).

•    Overall Treatment Duration: Tailored to each dog, based on the physiotherapist's judgment. It ended either upon achieving independent SW or when no further progress was deemed likely (median duration: 74 days across the study population; range: 10–370 days).

Additional Implementation Notes

•    Personalization: Exercises were customized based on the dog's specific needs, lesion type (e.g., IVDE or trauma), and response to therapy.

•    Hospitalization Regimen: 80% of dogs (65/81) were full-time hospitalized, but the treatment protocol remained consistent for day-hospital cases.

•    Monitoring and Progression: Progress was assessed ongoing, with adjustments like increasing UWTM time tied to observable improvements (e.g., emergence of pelvic limb movements). Absence of pain perception was confirmed throughout.

•    Surgical Considerations: For dogs that underwent surgery (e.g., hemilaminectomy for IVDE or stabilization for trauma), UWTM was delayed minimally to allow healing.

Why This Matters 

This provides practical insight for counseling owners. We often associate no pain perception with a grim outlook, but this suggests that with commitment to physio, many dogs—especially young, small ones—can achieve a functional, involuntary gait. It doesn't restore voluntary control or sensation, but it means better quality of life: less dragging, easier management, and more independence.

REFERENCE

Gallucci A, Dragone L, Menchetti M, Gagliardo T, Pietra M, Cardinali M, Gandini G. Acquisition of Involuntary Spinal Locomotion (Spinal Walking) in Dogs with Irreversible Thoracolumbar Spinal Cord Lesion: 81 Dogs. J Vet Intern Med. 2017 Mar;31(2):492-497. doi: 10.1111/jvim.14651