Hey Gang, Laurie here. Occasionally, I get questions to my FourLeg e-mail from pet owners. The following is one of those. I'm including it here because I think it tells an interesting story... and maybe something can be gained from my reply as well.
hi laurie,
My seven-year-old German Shepherd has just been diagnosed with fibrotic myopathy. she holds up her back left leg slightly. Unfortunately, she also has OCD, and we use exercise as her therapy! I am devastated. But, I have been referred to a physical therapist, who also suggested massage therapy. I’m not finding the physical therapy exercises very useful, I’m not sure the underwater treadmill is benefiting my dog, and these treatments are ridiculously expensive, $175 per visit.
my PT vet also has a massage therapist that she works with, and I have been trying to get on her schedule. I am wondering if I should forgo the PT exercises, and just focus on learning how to stretch and massage her. I’m on a fixed income, and although I do have pet insurance, the cost of PT is quite prohibitive. I would much rather focus on treatments that will provide her with the most benefit going forward, especially since she was only seven!
they’ve also mentioned an “assisi loop”, is that a helpful option?
my regular vet missed this for months even though I was insisting on xrays, finally I went to her knee surgeon (she’s had both knees done and plates removed), who also missed it. she has arthritis in both of her knees, and that’s what everyone was focusing on. Thankfully the PT vet diagnosed it right off the bat. But now I am just trying to move forward, and I really don’t even know who to talk to about what the best treatment for my dog is. The physical therapy approach has been haphazard, and the visits have not been scheduled cohesively because they are so busy. Same thing with the massage therapist, but I feel that at least if I have a consultation with her, I could learn the techniques my dog needs - ???
I would really appreciate any input that you might have, or any suggestions. i’m just not sure what to do! Thank you very very much!
judy
Fibrotic Myopathy Question
Fibrotic Myopathy Question
LAURIE EDGE-HUGHES
Re: Fibrotic Myopathy Question
Hi Judy,
Firstly, sorry for my tardy reply.
Okay, now as for your dog, I’m afraid I’m not going to be able to give you the magical cure. There isn’t one. I have had success in the past with ONE German Shepherd whose fibrotic myopathy was trauma related. Stretching the daylights out of it made a difference to her. Otherwise, most dogs don’t do much better at all. I tell people to focus on function and treat the compensation issues.
So… will massage, Assisi loop, underwater treadmill, modalities such as laser improve your dog? No. Save your money.
I would learn how to stretch the hamstrings so as to provide some sort of directed therapy and/or prevent worsening of the condition.
The good news is that this isn’t a painful condition. Think of it more like a mechanical restriction (i.e. the tightness limits movement, not pain.) So the movement looks odd, but it’s not a lameness like what you would get from a painful joint.
Where you could continue on with PT in some capacity would be to occasionally check up / treat her knees and spine.
Depending on the cost of the massage therapy (or if the practitioner is unwilling to show you what to do at home), you might alternately consider taking an online canine massage course to be able to do this at home. Ironically, I have one that is currently on sale right now. (Not trying to push it… but it might actually be what you want in regards to learning massage.) https://www.caninefitness.com/index.php ... age-Course
Beyond that, my best advice to you would be to learn to appreciate the dog you have now. Fibrotic myopathy doesn’t really go away I’m afraid (other than that one odd case I had about 20 years ago!) I wrote a blog on that topic (it’s about old dogs, which 7 isn’t… but you have a dog with a funky gait now, and that’s all it is. A funky gait. There are so many worse things. And this won’t stop your dog from enjoying life.)
https://www.fourleg.com/Blog/447/Transi ... g%E2%80%99
Wishing you the best of luck!
Cheers,
Laurie
Firstly, sorry for my tardy reply.
Okay, now as for your dog, I’m afraid I’m not going to be able to give you the magical cure. There isn’t one. I have had success in the past with ONE German Shepherd whose fibrotic myopathy was trauma related. Stretching the daylights out of it made a difference to her. Otherwise, most dogs don’t do much better at all. I tell people to focus on function and treat the compensation issues.
So… will massage, Assisi loop, underwater treadmill, modalities such as laser improve your dog? No. Save your money.
I would learn how to stretch the hamstrings so as to provide some sort of directed therapy and/or prevent worsening of the condition.
The good news is that this isn’t a painful condition. Think of it more like a mechanical restriction (i.e. the tightness limits movement, not pain.) So the movement looks odd, but it’s not a lameness like what you would get from a painful joint.
Where you could continue on with PT in some capacity would be to occasionally check up / treat her knees and spine.
Depending on the cost of the massage therapy (or if the practitioner is unwilling to show you what to do at home), you might alternately consider taking an online canine massage course to be able to do this at home. Ironically, I have one that is currently on sale right now. (Not trying to push it… but it might actually be what you want in regards to learning massage.) https://www.caninefitness.com/index.php ... age-Course
Beyond that, my best advice to you would be to learn to appreciate the dog you have now. Fibrotic myopathy doesn’t really go away I’m afraid (other than that one odd case I had about 20 years ago!) I wrote a blog on that topic (it’s about old dogs, which 7 isn’t… but you have a dog with a funky gait now, and that’s all it is. A funky gait. There are so many worse things. And this won’t stop your dog from enjoying life.)
https://www.fourleg.com/Blog/447/Transi ... g%E2%80%99
Wishing you the best of luck!
Cheers,
Laurie
LAURIE EDGE-HUGHES
Re: Fibrotic Myopathy Question
hi laurie,
THANK YOU so very much for your response. My apologies for taking a while to get back to you, things have been crazy I’m sure for all of us.
I already do sincerely and incredibly appreciate my dog more than words can describe. It’s incredibly helpful to be reassured that this is not a painful condition. The biggest challenge I have with her, is that she has OCD, she is a tail chaser. She has been a very challenging dog, it took me a couple of years to get the right meds combination, but the other tool I used to manage her condition was of course exercise: I ran her on a bike, and if I can find somewhere to throw a ball for her even a few minutes a day, it changes both of our lives. they are all telling me that I can no longer run her on the bike due to her knees, and I shouldn’t be throwing the ball for her either. finding a way to satisfy her need for activity has been the biggest challenge I am facing in all of this going forward!!!! i’m looking into bike trailers just to get her out more.
I did eventually have a session with the massage therapist, and she showed me how to stretch out her leg. I have three more visits left scheduled for next month, that combine an underwater treadmill workout and massage training session, but honestly I’m debating whether to even keep those appointments, with everything going on. so I appreciate your frank advice about all of the extra modalities they suggest, which supported the decisions I had already made to just stick with the massage. i’m relieved this at least is not painful, i’m just worried would it progress to where she can’t walk? that’s my only worry.
so thank you again, i really appreciate your input and thanks for taking the time to get back to me!
Judy
THANK YOU so very much for your response. My apologies for taking a while to get back to you, things have been crazy I’m sure for all of us.
I already do sincerely and incredibly appreciate my dog more than words can describe. It’s incredibly helpful to be reassured that this is not a painful condition. The biggest challenge I have with her, is that she has OCD, she is a tail chaser. She has been a very challenging dog, it took me a couple of years to get the right meds combination, but the other tool I used to manage her condition was of course exercise: I ran her on a bike, and if I can find somewhere to throw a ball for her even a few minutes a day, it changes both of our lives. they are all telling me that I can no longer run her on the bike due to her knees, and I shouldn’t be throwing the ball for her either. finding a way to satisfy her need for activity has been the biggest challenge I am facing in all of this going forward!!!! i’m looking into bike trailers just to get her out more.
I did eventually have a session with the massage therapist, and she showed me how to stretch out her leg. I have three more visits left scheduled for next month, that combine an underwater treadmill workout and massage training session, but honestly I’m debating whether to even keep those appointments, with everything going on. so I appreciate your frank advice about all of the extra modalities they suggest, which supported the decisions I had already made to just stick with the massage. i’m relieved this at least is not painful, i’m just worried would it progress to where she can’t walk? that’s my only worry.
so thank you again, i really appreciate your input and thanks for taking the time to get back to me!
Judy
Re: Fibrotic Myopathy Question
Laurie,
I just recently evaluated a GSD with a diagnosis of Fibrotic Myopathy who is 3 years old. I instructed mom in HS and gracilis stretches and massage. He is not very cooperative with stretching so she is focusing on active stretches. She has been advised to do PRP by a local orthopedic and is also considering stem cell. Do you have any information on if these could be successful? I also was thinking if US could be done over fibrotic area (if we can get him to tolerate it) would that help break it up a little possibly. I will pass along your remarks to her and it is a good note to focus on it not being a painful condition just a funky gait. He only gets about 100 degrees of stifle extension during swing phase of gait (with lower leg IR at end range).
Thanks for your thoughts. This case finally made me join the forum ; )
Lisa Saez, PT, CCRT
Dalia's Doggie Rehab in NJ, USA
I just recently evaluated a GSD with a diagnosis of Fibrotic Myopathy who is 3 years old. I instructed mom in HS and gracilis stretches and massage. He is not very cooperative with stretching so she is focusing on active stretches. She has been advised to do PRP by a local orthopedic and is also considering stem cell. Do you have any information on if these could be successful? I also was thinking if US could be done over fibrotic area (if we can get him to tolerate it) would that help break it up a little possibly. I will pass along your remarks to her and it is a good note to focus on it not being a painful condition just a funky gait. He only gets about 100 degrees of stifle extension during swing phase of gait (with lower leg IR at end range).
Thanks for your thoughts. This case finally made me join the forum ; )
Lisa Saez, PT, CCRT
Dalia's Doggie Rehab in NJ, USA
Re: Fibrotic Myopathy Question
Yah Lisa!
Glad you hopped on the forum!
So, I wouldn't waste money on stem cell or PRP. There is no research. And from a clinical reasoning standpoint... what would be the goal of PRP or stem cell. It can't go in and lengthen the scar tissue. At this point, I'd say it's most likely just a form of experimentation.
If you think of it as scar tissue, then perhaps US and slow myofascial release types of stretches MIGHT help a bit. (However... it's been tried, and nobody is finding a miracle cure.) Perhaps it can make a little bit of improvement, but again, not a cure.
Thanks for adding to the discussion Lisa!
Cheers,
Laurie
Glad you hopped on the forum!
So, I wouldn't waste money on stem cell or PRP. There is no research. And from a clinical reasoning standpoint... what would be the goal of PRP or stem cell. It can't go in and lengthen the scar tissue. At this point, I'd say it's most likely just a form of experimentation.
If you think of it as scar tissue, then perhaps US and slow myofascial release types of stretches MIGHT help a bit. (However... it's been tried, and nobody is finding a miracle cure.) Perhaps it can make a little bit of improvement, but again, not a cure.
Thanks for adding to the discussion Lisa!
Cheers,
Laurie
LAURIE EDGE-HUGHES