Hi Laurie
I saw a young lab yesterday that developed a suspected lumbar FCE (likely at about L2-3) 2 weeks ago when he was out running/playing. Has created a LHL monoparesis and dog is already starting to improve. He can walk a bit on the leg, knuckles with every step, but owner noticed that he did plant it properly a couple of times in the past day. He seems to be steadily improving and can now urinate fully on his own. I am working on his compensation issues - marked rt TL paraspinal spasm and rt sternocephalicus m is really sore.
The dog has marked decrease on LHL hip abduction and the Adductor muscle is hypertoned and when I put the hip into abduction the adductor muscle (and maybe the pectinus) actually go into clonus. When I put the LHL into abduction and slight hip extension, I get a significant tremor on the left lateral ventral abdominal muscles. Is this clonus an expected occurence with the FCE? The owner noticed some abdominal fasciculations starting about 2 days ago.
I am able to break the clonus by making the dog purposely flex the stifle and then I can slowly work on abduction with STM on the adductor muscle, but if I push it too far the clonus restarts. Am I best to leave LHL hip abduction alone at this time due to the clonus, or continue to work on ROM but just go extremely slow.
I've rigged up a tensor bandage wrap around the middle toes of the LHL and up around the hock and it is working well to plant the leg properly during a slow walk. Also working on AROM by annoying the toes, PNF bicycling/scratching the chest etc and weight shifting exercises.
Any other thoughts for HEP and the clonus situation?
Thanks so much
J.S.
FCE and Clonus Complications
FCE and Clonus Complications
LAURIE EDGE-HUGHES
Re: FCE and Clonus Complications
Hi J!
So with the clonus or any adverse neurologic reaction, you are doing right by stopping the reaction (i.e. flexing the hip) to break the clonus before carrying on with the activity.
I would do as much as possible in standing - weight shifting, e-stim, even ROM.
Clonus isn’t specific to FCE. It’s a sign of upper motor compromise (Spinal cord damage).
So, from a therapy stand point, if you’re not already, I’d also do laser or acupuncture and some manual therapy in the cranial L/S & T-L junction (to improve blood supply), and I’d have the owners doing tail pull traction as an additional therapy for the spinal cord compromise.
For home program on the owners part - add stuff in standing. Slow walking with proper foot / leg placement if possible (this is where a treadmill is great b/c you can MAKE the dog walk and at a pace you can work with).
If you’re able to send a video, perhaps I can come up with more specific ideas!
I hope this helps a bit!
Cheers,
Laurie
So with the clonus or any adverse neurologic reaction, you are doing right by stopping the reaction (i.e. flexing the hip) to break the clonus before carrying on with the activity.
I would do as much as possible in standing - weight shifting, e-stim, even ROM.
Clonus isn’t specific to FCE. It’s a sign of upper motor compromise (Spinal cord damage).
So, from a therapy stand point, if you’re not already, I’d also do laser or acupuncture and some manual therapy in the cranial L/S & T-L junction (to improve blood supply), and I’d have the owners doing tail pull traction as an additional therapy for the spinal cord compromise.
For home program on the owners part - add stuff in standing. Slow walking with proper foot / leg placement if possible (this is where a treadmill is great b/c you can MAKE the dog walk and at a pace you can work with).
If you’re able to send a video, perhaps I can come up with more specific ideas!
I hope this helps a bit!
Cheers,
Laurie
LAURIE EDGE-HUGHES