I'm hoping you can give me some advice. This is an amazing patient with wonderful people.
Oli is a 7 year old MC Bernese Mountain Dog. In December 2014, he was diagnosed with an FCE vs. Hansen type 2 disk via MRI at University of Penn. I did not start seeing him until April 2015. At that time he had significant paresis in his hind limbs. I've worked with him for the past two years doing anything and everything I can think of to help this guy walk again -NMES, manual stimulation of HL with any kind of object I can get my hands on, laser, PEMF, manual therapy, UWTM, swimming, land treadmill, ther-ex (including with our Enliten hoist system - check it out if you have time). Clients work with him at home and he has an Eddie's Wheels cart, tarsal supports (as he has laxity.) He also receives acupuncture every other week. He has motor in his hind limbs but is weak and unable to get the feet under him to stand and walk. He seems to wax and wane in his progress and has recently had some significant set backs with very resistant UTIs and some very negative reactions to the antibiotics used to treat him. He is bright and happy now. So the latest wrinkle is that he has torn his right cruciate ligament.
. So I'm not really sure where to go from here. Initially, the ideal goal was to get him strong enough that we could get him up and walking. I think over the past 6 months or so we have changed the goal to maintain him as he can move around on his own using primarily his fore legs with some help from his hind legs (does kind of a "knee walking" thing.) His ROM is good and he doesn't seem to be in pain but his hind leg sensation is not normal so it is hard to say. I was thinking about continuing with the modalities as well as low/no impact exercises - weight shifting including with fore paws elevated, cookie stretches, three legged stands, more UWTM, swimming- all things we have done in the past. The clients have no interest in surgery and even if they did, I'm not sure that would even be that beneficial in this case. Any pearls of wisdom you could share would be greatly appreciated.
N.