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Hi Laurie,

I'm seeing an 11yo, 57lb, Aussie mix. She presented to the specialty center in mid-March with a 1-week history of rear limb weakness. History of a Left TPLO in 2013. Rads reveal severe disc space narrowing and spondylosis from T3-T7. Severe spondylosis also noted in thoracolumbar spine. Disc space narrowing at T12-T13. Neurologist also noted moderate bilateral iliopsoas pain. R/Os include IVDD, FCE. (Spondylosis deformans in multiple sites through the thoracic and cranial lumbar spine are likely culprits.) Due to sudden onset, DM is unlikely at this point.

I saw her in mid-April and the rear limb weakness has progressed from episodic to consistent ataxia, paresis, and limited CP bilaterally.

Here's the challenge: Mentally, this dog wants to move, wants to go for walks, chase her tennis ball, be engaged with the other dogs in the home. What parameters do you use to balance QoL, mobility, and managing the psoas strains? If you restrict exercise for a dog in this neuro condition, you may lose the last few months this dog has to be active and engaged. If you get them mobile (cart, etc.), you risk causing further damage to the psoas. In my head, I want this kid moving as much as possible. Continue manage

A question on exercise, as well. I know UWMT is not a good idea for iliopsoas injuries. What about swimming? It's a much more flexion-based exercise with significantly less caudal thrust of the rear limbs. This dog is an experienced swimmer so there won't be thrashing and uncontrolled movement in the water. I love swimming for my dogs with neuro issues, especially those that are ataxic and paretic. The confidence lift is huge as they get to practice moving without the stress of keeping the back half of the body up, moving in a straight line, and wobbly gaiting.

Any advice would be greatly appreciated.

Thanks,

K

Hi K,

Okay… So Spondylosis doesn’t cause sudden onset neurologic signs. In fact, it doesn’t usually cause neurologic deficits. The adjacent hypermobile segments are usually degenerative and are what’s associated with neuro signs. IVDD, FCE are more likely.

Bilateral iliopsoas strains are not likely either. I’d put money on the iliopsoas being facilitated / spasm because of nerve root irritation in the lumbar spine. Bilateral ilipsoas strains don’t happen without some sort of trauma, and most non-rehab vets don’t understand facilitation of the iliopsoas.

Okay, so then on to ‘what to do’. In addition to trying to find the root of the problem to treat it (i.e. laser, traction, tail pulls, mobilizations, PEMF, acup) then mobility is important. I don’t think you need to fear iliopsoas problems by putting her in a cart. I’ve never had that happen. I do like a neoprene seat versus a rigid seat so that legs can move. I think being able to go out, sniff, play etc. is very beneficial mentally and physically.

In regards to water exercising… don’t worry about the iliopsoas (yes, as an exercise for a dog with iliopsoas strain, it’s not great), but you don’t have a primary iliopsoas strain. You have a facilitation. So think of it instead as a symptom of the spinal injury / inflammation versus an issue in and of itself. Back to water… I like to think of things in regards to what is the goal? What would be the best bang for their buck? As such, a wheelchair would do that. More frequent, daily movement would be better than once or twice a week in water (whether UWT or pool). Not to say that you can’t do those things, I just look at it as where do you put your money & time first. In my head, it’s a w/c. So your instinct is correct, get her moving. (And treat the ‘root’ of the problem… as best you can localize it.)

I hope this helps a bit!

Cheers,

Laurie