fourleg.com

Hi
If you have the time I would appreciate your input on this case. It is a neuro case and I'm yet to get some decent neuro rehab training - I have a little knowledge but some more training is on my list.


I've attached a dropbox link with a few short few videos of the dog
https://www.dropbox.com/sh/91wyzoyxu05p ... G476a?dl=0

Tatiana is a 15 month old dog with neurological issues. The history is she was born with no issues and then at about 5-6 months after playing with other dogs she was unable to walk. She slowly made a recovery and was able to walk but was left with some neuro issues.
She is cognitively normal. Her gait is slightly ataxic + slightly hypermetric but quite functional. She loses balance occasionally. I tested her over cavaletti rails and she negotiated them fine.
She is slow with placement reflexes then suddenly hyper-reflexic. You can see this with different tests in the videos. She is slow then seems to overcompensate.
The other issue I am seeing is when she is moved quickly especially up and down it seems to over trigger the extensors and all 4 limbs show marked spasticity. If she is moved slowly the spasticity is not triggered. It's like her "accelerometer" is broken.
She seems also to have very small intention tremors.

Owners won't go to CT or MRI. So I'm having to guess on where the issue is - I think it has to be a central vestibular issue - vestibular apparatus/ cerebellum. The history of a trauma cause doesn't really fit ?? so there could be a congenital issue?

My thoughts for rehab was getting the owners to try and establish some normality in Tatiana's proprioception. I asked them to
- repeat the proprioception tests (1. sliding the back of the paw up to an edge and 2. keeping one front paw on the ground and sliding sideways)
- peform pertubations while the dog is sitting and walking to try and rewire the propioception
- lift the dog slowly and place her down slowly without triggering the spasticity to try and get normal response as she touches the ground - as she improves slowly increase the speed of lifting her up and putting her down.
- if possible do all these tests on different surfaces - grass/ carpet/ pebbles etc to try and get different proprioceptive input.
- rocking backwards and forwards on a peanut or similar alternating between front feet touching and back feet touching.

Hope some of this makes sense. Am I on the right track? Do you have any other suggestions? Is there anything you can suggest to reduce the spasticity?

Thanks
Steve

Hi Steve!

FINALLY I can reply to this! I've tried before, but the Forum was down. I"m sorry about that!

Okay, so I would assume the same in regards to central vestibular. The only thing I can think of in regards to sudden onset however would be trauma to the head that could have done damage to the utricle or saccule in the inner ear (as that would account for the up down causing a vestibular type reaction). The other one I'm wrestling with is atlanto-axial subluxation... but the extensor spasm / splayed limbs when being lifted or put down with speed doesn't fit any other A-A dog I've ever seen.

So, if we go with Vestibular. Then you are very much on track. I like all of your ideas.
I would incorporate eye exercises as well: Hold the head and move a cookie from side to side. Then hold a cookie in place and move the head.
You could progress to doing some balancing exercises blind folded (so as to rely on the vestibular system more). Try moving her up and down with a blind fold on as well.
You could try getting her to move her head while walking (luring with a treat while walking... easier on a treadmill I'd think - but throwing it out there as something to try just the same).
(See the Vestibular Left Overs video)

The other thing I'd do and I'm doing more of in cases like this... or any case where brain could be involved is laser the brain. Laser can penetrate (see the Laser Update Videos). I've found it to have a good effect in many cases! I aim for the temporal lobes - and Class 3B.

I hope this gives you some ideas... and my apologies for not being able to reply sooner!

Cheers,

Laurie

Thanks - much appreciated