Wobblers dog with dropped Tarsus

[lehughes]

Hi Laurie!

My name is Sarah. I am an animal health technician who completed my CCRP in Dec 2019 and have been doing rehabilitation out of a small animal hospital ever since.

I'm hoping you can offer your input on one of my patients.

Jamon is a 10 yr old Rott X who was diagnosed with Wobblers back in October 2019.

Summary of the MRI:

1. Severe vertebral canal stenosis at C6-C7 with deformity and compression of the spinal cord. The stenosis at C6-C7 is believed to be caused by remodeling of the articular facets.
2. Inflammation of the meninges at C6-C7 suspected due to the compressive nature of the lesion.
3. Mild intervertebral disc extrusion exacerbating the canal stenosis and cord compression at C6-C7 is also possible; mild disc protrusions at C2-C3 and T3-T4 without significant spinal cord compression

I have been seeing him in for rehabilitation regularly ever since and implementing a lot of your protocol since the beginning. He was doing very well!

Now for a few reasons outside of my control, I was unable to see him for about 6 weeks (he was coming every 2 weeks for laser, traction, proprioception work and strengthening). The owner reports a large decline in the past 2 months, notably decreased proprioception on the left him, he will often knuckle. I attached a photo and video I was sent of his gait.

I was wondering if you had any suggestions for his left tarsal joint that appears to have dropped quite low. Can this be weakness only?

To complicate things - due to covid, I am unable to be in office and have a colleague of mine implementing my treatment plans (she is an experienced animal health technician who is currently completing her CCRP), but I can't physically put my hands on him, I guide her and modify treatment plans remotely.

Thank you for your time and expertise!

S

Video Link (right click to open in separate window / tab)
https://youtu.be/DtI84d3FJtw

[lehughes]

Hi Sarah,

So, I think you have a new problem now in this dog.

Likely because of the weakness, it would appear that there may have been a partial tear to the Calcaneal Tendon - like the Superficial Digital Flexor component.
Ughhh…
Normally, a brace would be a no-brainer. The concern with bracing a neuro dog is the lack of proprioception / awareness of the leg you would be bracing… which makes learning to use the brace a bit tricky AND the dog’s ability to clear the ground with the brace a bit tricky also.

So, I would lay out the following options:

1. Try a Custom Tarsal Wrap - perhaps with added Thermoplastic for support - for you, the contact for such a thing would be www.therapaw.ca (for the Canadian distributor / custom manufacturer). This may or may not work. It might not be enough support. BUT it allows the foot to be free to ‘feel’ placement on the ground.
2. If #1 isn’t enough, of the owners just want to skip to this right away, then one of the custom hard brace/orthosis companies - Hero, Orthopets, or K9 Orthotics. These will definitely protect the tarsus, but will be more difficult for a neurologically compromised dog to manoeuvre - at least at this stage. Here the risk is that the owners spend what will likely come to $1500CAD (all things considered) on a brace that the dog might not be able to move in.
3. Do you try a pre-fabricated over the counter version first… with a huge caveat that it’ll most likely be total garbage!!

So, I guess, I might start with option 1. BUT, it’s likely good to bring the owners in on the conversation.

I’m also going to post this on the FourLeg Forum and you can check on there to see if anyone has other ideas as well.

Best of luck!

Laurie