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Hi Laurie,

I hope you don’t mind me emailing you.
I took the intro course in Calgary a couple of years ago and have been doing a small home care business for dogs, mainly Senior dogs and CCL injuries. Today I picked up a client with a malformation to the hind limbs.
She is a very tiny Yorkie, 3.5 years old. Her hind limbs are in a Varus position and there is decreased stifle extension and hock dorsiflexion, right side more so than left. She does not like to stand and is only standing with gait. She has a kyphosis to the lower thoracic spine and is able to achieve a neutral head position but tends to flex forward/down. She is not food motivated, very gentle but difficult to do exercises with as she refuses to stand. I’m unable to test her reflexes in stance.
I’ve started her on a bathtub/hydro therapy program and some PROM exercises.
There are no definitive tests from the veterinarian, who is a holistic vet.
I’m wondering in your experience if bracing or splinting would help a little dog like this.
Any suggestions would be greatly appreciated as I’ve yet to encounter a dog like this in my few years of practice.

Thank you,

C.

Hi Carol,

Your patient sounds a bit overwhelming. So, I would take a step back and look at the whole of the dog in order to do some deductive reasoning. The spine and head position you describe sounds to me like a dog that is trying to offload the rear legs. So spine & neck are secondary. You can come back to those at a later date.
The legs: Now given the leg posture you are describing, and the fact that she’s a yorkie, and the fact that she’s trying to offload the back end and doesn’t really want to stand, I think I’d put money on her problem being patellar luxations. She could be a grade 4 - maybe they’re permanently displaced, and the bones are misshapen. Or maybe they’re grade 2’s, and she has learned how to hold her legs to minimize quads use and therefore pulling on the patella. (I saw this in a Chihuahua once. I had to get her relaxed enough to get a good test - took me 20 minutes. And I could then get them to luxate. Sent her back to the vet, and then to the surgeon - but she couldn’t get them to luxate. Fast forward 1 year later, she was severely luxating and walked in the posture / leg position you described, enough so that NOW when I said that she had luxating patellas, and the referrals was again made to the surgeon - the surgeon was able to find them! Not a bad surgeon, it’s just that she didn’t spend 20 minutes getting the dog to relax enough to get a good test.)
And of course, with MPL, there is a correlation with CCL tears… so the problem may be multiple.

So… if they are open to a surgical consult, I’d advise that. If not then follow my MPL protocol to try to strengthen as much as possible (mini sit to stands being most important - i.e. sitting down to a platform, not a full sit. x many many reps).

Best of luck!

Cheers,

Laurie