??Laser therapy in a patient with possible Geriatric Wobblers and IMPA (in remission)

[JuliPotter]

Dear Laurie
I know I have posed this question before but here goes....so I am working with a 15 year old FS hound mix. The owner's concern is that Jill's back legs shake after rising from resting and after exercise. They do not feel that she has any difficulty getting around but feel that she is more confident walking in the kitchen now that they have put down a non slip surface for her to walk on. Upon presentation, I noticed that she shifts her weight forward while standing and her front legs appear to be under her body, there was also slight abduction of the right elbow while standing. CPs are normal and I did not notice obvious ataxia but her stride is shortened and stiff in the rear and I thought she had a slight hypermetric gait in the front limbs while walking. She definitely has muscle loss in both the right and left quads and hamstrings and gluteal muscles. Her quadriceps are quite tight and her hamstrings- low tone. Jill does not really like being touched much according to her owner and she is a shy girl so I was not able to complete my exam of her pelvis and pelvic limbs but I did find that she resists flexion alone and with rotation to the right of her neck, she was reactive (moved away) with side glide of C3/C4 and C6/C7 and this was repeatable. While attempting to evaluate her T-spine and ribs, she was quite resentful, especially between the scapulae, even with the slightest pressure and she was warm to the touch at the T-L junction. Her paraspinals did feel tight to me and it was easy to palpate the spinous processes of the T-spine and L-spine but I can't say that I appreciated muscle atrophy. I did notice atrophy of both supraspinatus muscles and her triceps with the right more so than the left, her triceps were quite tight and I thought her teres major was tight as well. She has reduced carpal extension as well as reduced shoulder extension, pure glenohumeral, bilaterally. She did fall to the side when I gently lifted her right forelimb; I did attempt to support her while doing this. My assessment is that her symptoms are due to degenerative disk disease of C6/C7 (geriatric Wobblers?) with secondary tightening of the surrounding soft tissue maybe due to pain as well as shifting her weight forward. I am really anxious to better evaluate her pelvis, Iliopsoas and pelvic limbs! As well, Jill was diagnosed with immune mediated polyarthritis about 2 years ago and appears to be in remission. I am wondering, do you feel it would be safe to use laser therapy for Jill? I would like to laser C6/C7 ....and may find other indications once I can complete my exam!
To start, I plan to do manual therapies for pain and hope to help relieve some of her muscle tension and shortening as well. Thanks so much!!
Juli

[lehughes]

Hi Juli!

Okay... so the easy answer, is Yes you can laser for a suspected Wobblers.

I'd also try neck traction if she'll allow it, cranial thorax chest lifts, and some gentle mobilizations to C5 - T1/2. If any one vertebra is too tender, mobilize adjacent to it... there will still be benefit. (i.e. if C7 is too tender to mobilize, then mobilize C6 and T1).

Try some scalenes stretches or even just some myofascial stretches to the sides of her neck.

Yes to getting to the SIJ... but in a case that is as you described, I'd leave those poor iliopsoas muscles alone. You can assume they'll be tender.

This is actually a great case for laser. (Likely full body!!!)

I hope this helps! All the best!

Laurie

[JuliPotter]

Awesome!! Thank you, Laurie!!
Juli