Olive is currently an almost 9 month old F Great Dane pup who was acutely paralyzed 4 months ago- she was seen at UPenn and we never got a firm diagnosis despite MRI's, CSF taps and titers galore. They were concerned about a breed disposition to Wobbler's, but there must have also been an acute injury as she acutely went down and was non-ambulatory. At that time she also had Horner's. Her MRI revealed some evidence of underlying Wobbler's but the changes were mild but there was also evidence of myositis (left subscapularis) and myelitis with an intramedullary caudal cervical lesion at C5-6-7). She was negative for Neospora and they monitored her for Rabies for 10 days (as she is NOT fully vaccinated and never had a rabies) while also starting her on prednisone and clindamycin.
I know the history is disjointed but we have no firm diagnosis - we have finally weaned her off prednisone as of a month ago and she has gone from laterally recumbent at discharge with no motor at all and unable to right herself to almost being able to stand and walk on her own (Can do assisted). She still maintains a two engine gait. Understandably having a downed giant breed puppy has been hard and she boards with us during the week for intensive rehab/acupuncture and goes home for the weekends. She also has carpal laxity syndrome - this was mild to start but not correcting itself and getting worse, especially in her left front leg which is her worst leg neurologically - if she looks down she will collapse on that leg. We have her braced with custom braces Ilaria from TheraPaw had made for her, which work wonderfully and enable her to actually bear weight!
Understandably, this pup struggles the most due to her size - thankfully this seems to have "stunted" her growth a bit and she is still at 90 lbs with fair muscling - we have a cart and she does walk 3-4 times a day, we make sure she spends approximately an hour a day total minimum bearing weight.
What I struggle with now is the kyphosis developing in her lumbar spine. We struggle to engage her core - part of this is how she chooses to move herself around (and I have seen this in puppies who are so much more stretchy to begin with!) - she will move herself around and try to drag if given the option and compress her lower back, she lays down in an extreme curve - and when she walks if we assist even the Help Em Up Harness causes some extra "lift" of the pelvis and contributes. We work on front feet elevated and standing in this position, I manually will lay her down and stretch her back but we are losing flexibility - any other exercises that you think will be helpful?
I will try to get a video and picture to show what I mean!
9 month old tetraparetic Great Dane
Re: 9 month old tetraparetic Great Dane
Hey Kim!
So, firstly, Wow! Ugh! Cool! Good job so far! I don't envy you! ETC, ETC!!!
Okay... so because this sounds to be an extremely complicated case, with no diagnosis (thus no expectations, and a multitude of variables), we have to start with breaking this down into just the problems at hand.
Your treatments thus far sound good... and I quite like your weight bearing plan of attack!
Now onto the lumbar kyphosis. I'm going to play devil's advocate first, and question whether it's something that needs to be addressed or not. Presumably it's there because she is overworking some portion of her abdominals in how she is moving around around thus far. So, is it functionally adaptive or causing a hindrance at this point? (I don't know the answer... maybe a video will help - ps upload to youtube and then post the link here.)
If we go with the premise provided that it is maladaptive and causing a hinderance, then it's not the 'core' per se (i.e. abdominals) that you need, but rather the lumbar epaxials, and proximal stabilizers (i.e. gluteals) to engage on a more regular basis to counteract the floor activity that is causing the contracture. Off the top of my head, I would try the pelvic tilt exercise with her - assuming she can get into a sternal recumbency position. Also, cookies into extension / from above, to get active extension in sternal, sitting, & standing. Perhaps work with side flexions too... just to enhance mobility of the spine in general. So even figure of 8's or weaving.
Glutes: Can she do anything in regards to sit to stand practice? Perhaps using a stool / coffee table / cement blocks, so she's not going all the way down. What about hill walking. And it doesn't have to be an extreme hill - perhaps a sheet of plywood (with a yoga mat on it) to go up an elevation of 1/2 - 1 foot - onto a platform... or a second sheet of plywood to go down. Thus getting glutes and epaxials. Now, in addition to the front feet up and standing, could you also add reaching forward slightly (i.e. to get a cookie) - again, I'm thinking active extension.
You'll likely also need to do the myofascial holds / prolonged stretching as well... but the active extension stuff might help the passive stuff to have more impact.
Okay - back to you!
Laurie
So, firstly, Wow! Ugh! Cool! Good job so far! I don't envy you! ETC, ETC!!!
Okay... so because this sounds to be an extremely complicated case, with no diagnosis (thus no expectations, and a multitude of variables), we have to start with breaking this down into just the problems at hand.
Your treatments thus far sound good... and I quite like your weight bearing plan of attack!
Now onto the lumbar kyphosis. I'm going to play devil's advocate first, and question whether it's something that needs to be addressed or not. Presumably it's there because she is overworking some portion of her abdominals in how she is moving around around thus far. So, is it functionally adaptive or causing a hindrance at this point? (I don't know the answer... maybe a video will help - ps upload to youtube and then post the link here.)
If we go with the premise provided that it is maladaptive and causing a hinderance, then it's not the 'core' per se (i.e. abdominals) that you need, but rather the lumbar epaxials, and proximal stabilizers (i.e. gluteals) to engage on a more regular basis to counteract the floor activity that is causing the contracture. Off the top of my head, I would try the pelvic tilt exercise with her - assuming she can get into a sternal recumbency position. Also, cookies into extension / from above, to get active extension in sternal, sitting, & standing. Perhaps work with side flexions too... just to enhance mobility of the spine in general. So even figure of 8's or weaving.
Glutes: Can she do anything in regards to sit to stand practice? Perhaps using a stool / coffee table / cement blocks, so she's not going all the way down. What about hill walking. And it doesn't have to be an extreme hill - perhaps a sheet of plywood (with a yoga mat on it) to go up an elevation of 1/2 - 1 foot - onto a platform... or a second sheet of plywood to go down. Thus getting glutes and epaxials. Now, in addition to the front feet up and standing, could you also add reaching forward slightly (i.e. to get a cookie) - again, I'm thinking active extension.
You'll likely also need to do the myofascial holds / prolonged stretching as well... but the active extension stuff might help the passive stuff to have more impact.
Okay - back to you!
Laurie
LAURIE EDGE-HUGHES
Re: 9 month old tetraparetic Great Dane
CoonHound paralysis? how is the dog doing now?