6 year old MN Boston Terrier with possible autoimmune spinal cord ischemia mild disc lesions and shoulder hyperextension

[JuliPotter]

Thank you so much, Laurie!
based on your reply, I am wondering if the SIJ dysfunction in Mason is secondary to the loss of muscle mass of the gluteal muscles, the quads and the hamstrings which occurred after the onset of symptoms related to the large amount of inflammation in his C-spine found with MRI (believed to be secondary to an autoimmune disease).
but When you mention lumbarized S1/sacralied L7, I think transitional vertebrae which tend to be seen in Malinois and GSD....can we see this in other breeds? I have certainly noted pain in Mason at the L-S junction before.....I know this may sound like a stupid question, Oh I have so much to learn, but with these symptoms, do you think it would be beneficial to get radiographs of the lumbo-sacral region?
Mason does seem to be stable now but he does still weight shift to the left in the rear when standing and he did "favor" this leg, per the owner, one day last week and then seemed back to "normal" the next day. Mason is a very active dog, though the owners have made some lifestyle changes (no longer throwing the ball in the air for him, rolling it instead, avoid jumping as much as they can, trying to limit slick surfaces) since his initial neurologic episode a year ago, I do feel that Mason has at least a Grade 1 MPL in both stifles. so his intermittent lameness could be related to trauma, muscle strain, patellar luxation?
We did start working on gluteal strengthening at our last appointment, specifically the motor control and timing exercise, and we started using K-tape as well, crossing from the gluteal muscles on the right to just behind the ribs on the left with an anchor across the SIJ and the owner feels that this has really helped. I am wondering, how do I know when to progress the exercises? For example, when is it safe to add in the Step Ups? Diagonal leg stands. Especially since he is still weight shifting and has occasional lameness....though I think this may depend on what I find during his next exam!! Thank you, Laurie for your patience with all my, what feels like, stupid questions!!
I do find it fascinating when all my learning seems to come together....for example, after learning more about SIJ dysfunction, I noticed my Shepherd has been chewing on the toes of her right rear foot, especially the 2nd and 3rd digit so I checked her spine and SIJ and low and behold, her pelvis was rotated!! Wow! My shepherd has had poor gluteal, and rear limb, muscle development all of her life, she is very sore with palpation of her Iliopsoas muscle bilaterally and of course, has over angulation in the rear! I love making these discoveries!! Thank you, Laurie for all that you do!!
Juli

[lehughes]

Hey Juli...

I'll reply to each question as best I can below:

SIJ causing Glute atrophy can be a reason for recurring SIJ dysfunction.

I have seen transitional vertebra in dogs other than GST or Malinois, yes. With Boston's and other 'screw tail' breeds, there is a known higher incidence of vertebral abnormalities as well... so worth contemplating. In regard to the need to do an x-ray. Would it change what you do?
(Personally, I think the answer is no. So, I'd save the owner some $$ in sending them down that path.)

I don't worry about Grade 1 MPLs / LPLs. I think they're very common and can show up as a dog ages or has a reduction in muscle mass, strength, or coordination.

When to progress strengthening exercises: When the dog is successfully able to do the lower level / current exercises, then you can progress. (i.e. if the dog can't do a 3-leg stand, then you don't progress to a diagonal leg stand.)
Additionally, you ask yourself, "Is the exercise I want to prescribe dangerous in some way to the dog at this stage in of his physical capabilities?" And if not, then you test the exercise during one of your sessions. If the dog is able to do the exercise safely (and the owner can demonstrate that he/she can do the exercise to your satisfaction) then you can prescribe it.

And I'm delighted that you learned something new in regards to potential pain generators / dysfunctions that can lead to an issue in your own dog! These things can make all the difference in the world!

Cheers!
Laurie

[JuliPotter]

Laurie,
You are amazing!! Thank you so much!!
my next post will be about the shoulder....right now I am struggling to determine normal versus abnormal feel......It has been fascinating to feel the differences between the shoulder of a Boston Terrier and a German Shepherd!!!
All my best,
Juli