Hi Laurie,
I hope you are doing well!
I am wondering if I might be able to get your input on a rehab case. I just saw a 7yr. old, M/N, French Bulldog for the first time yesterday. He appears to have sustained a partial brachial plexus injury approximately 2 months ago. Their rDVM recommended amputation, but they are wondering if there is any hope with rehab. I searched on your 4 leg rehab site and read the blogs that came up, and I am just wondering if you have any insight on prognosis or suggestions for rehab protocols.
During my evaluation yesterday, he showed signs of medial shoulder instability with the scapula stabilized, as well as pain on abduction of the right forelimb without the scapula stabilized. He is NWB on the right forelimb, with the elbow flexed and carpus danging, so I'm thinking radial nerve damage.
I would like to come up with an "ideal" rehab plan for the owners. I'm thinking twice weekly in-clinic visits for LASER, E-stim, PROM, acupuncture and ther. ex. Can you think of anything else I should add?
Thank you for your time and expertise!
With kindness,
RM
Rehab for Brachial Plexus Avulsion
Re: Rehab for Brachial Plexus Avulsion
Hi R.,
Sorry for my tardy reply. It has been a very busy last… well 485+ days to be exact!!! But yes, late May and early June have been busy busy!
So, with the dog being 2 months out from injury, I would hope that you would be seeing something. Some flicker of muscle with your e-stim (2Hz), or reflex testing, or e-stim + alligator clips attached to acupuncture needles. If not, then it’s likely a full tear of the nerve.
A nerve will grow at 1mm a day / 1 inch a month (and only if the sheath is still intact). If it’s not, then it will never grow back. So in 2 months time, you have the potential for 2 inches of growth. So, if you’re not seeing anything now. You won’t.
Now, that doesn’t mean they have to amputate. It does mean that your goal changes to function and secondary compensations (tight muscles and fascia). Do let a little bit of a contracture occur however - so that the limb doesn’t drag on the floor. But shoulder stretches, MFR, etc will be beneficial.
So, I guess, my actual suggestion is to test for it. (Watch the video Dad’s Nerve Palsy - Training Video 54).
I hope this helps.
Cheers,
Laurie
Sorry for my tardy reply. It has been a very busy last… well 485+ days to be exact!!! But yes, late May and early June have been busy busy!
So, with the dog being 2 months out from injury, I would hope that you would be seeing something. Some flicker of muscle with your e-stim (2Hz), or reflex testing, or e-stim + alligator clips attached to acupuncture needles. If not, then it’s likely a full tear of the nerve.
A nerve will grow at 1mm a day / 1 inch a month (and only if the sheath is still intact). If it’s not, then it will never grow back. So in 2 months time, you have the potential for 2 inches of growth. So, if you’re not seeing anything now. You won’t.
Now, that doesn’t mean they have to amputate. It does mean that your goal changes to function and secondary compensations (tight muscles and fascia). Do let a little bit of a contracture occur however - so that the limb doesn’t drag on the floor. But shoulder stretches, MFR, etc will be beneficial.
So, I guess, my actual suggestion is to test for it. (Watch the video Dad’s Nerve Palsy - Training Video 54).
I hope this helps.
Cheers,
Laurie
LAURIE EDGE-HUGHES