Hi Laurie,
Question.... Have you had o any canine in for rehab post-op elbow surgery with the new " P.A.U.L" method????? What can I do safely at 3 weeks post op?????
Thanks chicky!! PS : I actually love your family stories on the E-Blogs - your Canadian damnit.... its how we are!!!
K.C.
P.A.U.L. Method for elbows
P.A.U.L. Method for elbows
LAURIE EDGE-HUGHES
Re: P.A.U.L. Method for elbows
Now, as far as the PAUL method… I know nothing. I would treat it like a TPLO, and progress in a similarly staged way.
I’m going to ask a vet surgeon I know in Germany to find out the ins/outs good/bad/ugly about the surgery. I’ll let you know if he has anything to contribute! And I'll post on the forum to see if any of our members have information / ideas to share as well.
Cheers!
Laurie
Reference:
http://www.kyon.ch/current-products/pro ... otomy-paul
I’m going to ask a vet surgeon I know in Germany to find out the ins/outs good/bad/ugly about the surgery. I’ll let you know if he has anything to contribute! And I'll post on the forum to see if any of our members have information / ideas to share as well.
Cheers!
Laurie
Reference:
http://www.kyon.ch/current-products/pro ... otomy-paul
LAURIE EDGE-HUGHES
Re: P.A.U.L. Method for elbows
I have two post surgery PAUL cases. Both very young dogs. Both very dedicated owners.
I went very cautious and used an approach of acupuncture, post op elbow protocol as described by Laurie however did not progress nearly as fast as described because I felt very unsure on the first one so we took it deadslow. I found that both struggled very much with the UWTM after a while because they seemed to not progress. We have a pool at work and that proved to be for both these dogs the game changer once we got them to a certain fitness. They are both biomechanically lame but comfortable compared to pre surgery and on no conventional pain meds. They are both on chinese herbs/ nutraceuticals and have become regulars, they do home exercises and see me as soon as a blip happens. The orthopaedics signed them off way before I relaxed about them. As a technique I think it is very invasive and when this one goes wrong e.g post surgery complications I think you could end up in a really bad place so hence I was taking it very very slow. Good luck. Vee
I went very cautious and used an approach of acupuncture, post op elbow protocol as described by Laurie however did not progress nearly as fast as described because I felt very unsure on the first one so we took it deadslow. I found that both struggled very much with the UWTM after a while because they seemed to not progress. We have a pool at work and that proved to be for both these dogs the game changer once we got them to a certain fitness. They are both biomechanically lame but comfortable compared to pre surgery and on no conventional pain meds. They are both on chinese herbs/ nutraceuticals and have become regulars, they do home exercises and see me as soon as a blip happens. The orthopaedics signed them off way before I relaxed about them. As a technique I think it is very invasive and when this one goes wrong e.g post surgery complications I think you could end up in a really bad place so hence I was taking it very very slow. Good luck. Vee
Re: P.A.U.L. Method for elbows
I've rehabbed one PAUL surgery in an 11 month old cross breed whose owner is planing on doing the other side next year. Like Laurie suggested I also proceeded in a similar fashion to TPLO and once the post op radiograph showed the fracture site healed we ramped it up. Dog is doing great at 14 weeks post op with very little lameness visible.
Tracey
Tracey
Re: P.A.U.L. Method for elbows
Thank you both Vee & Tracey!
I also took the liberty of asking a German Vet Surgeon friend of mine, who also provided the following:
PAUL
Proximal Abducting Osteotomy
This procedure is designed for patients with medial elbow compartment syndrome as well as for patients with coronoid disease and only grade 2-3 chondromalasia. In this particular patients we perform a PAUL to get pressure away from the coronoid and try to stop the cartilage reduction.
The idea behind this surgery is to shift the weight baring part to the radius by abducting the proximal Ulna and drop the tip of the coronoid down, additionally.
You achieve this with an Ulna cut and pressure through the special designed plate.
With this surgery, you open the collapsed medial joint space. In second look arthroscopies new, fibrous cartilage.
We do this surgery on a routine base in dog older than 12 mth with coronoid disease and cartilage damage grade 2-3 and in dogs with MCD.
The dogs are doing very well after recovery. But.. the recovery phase is a long period.
We see severe lameness up to 6 month post op. The reason is first the ulna cut and second the underling disease process. It takes time to build fibrous cartilage.
Often the patients are quite good and the owner doesn't take enough care and the dog runs or jumps and gets a painful / lame. In this cases you have give these guys a rest period.
Rehab Plan we do
0 -2 week: joint mobs, PROM, RICE, weight shifting
2-4 week. Joint mobs, PROM, Rice, Isometric work.
4-8 : ads under water treadmill, Balance disc
8-12: add cavaletti
-6 moth add restrictions to the owner. We try to strengthen and start in the last 2-3 month with AROM work.
My idea is first cartilage development then joint movement. My concern is a acute on chronic onset of arthritis during the healing process
Hope that helps.
Looking forward to discuss with you Rehab of this guys.
Gereon
Dr.Gereon Viefhues CCRT
Certified Canine Rehabilitation Therapist
FTA für Chirurgie, FTA für Kleintiere
ZB Augenheilkunde, Zahnheilkunde,
Röntgenologie und Sonografie
I also took the liberty of asking a German Vet Surgeon friend of mine, who also provided the following:
PAUL
Proximal Abducting Osteotomy
This procedure is designed for patients with medial elbow compartment syndrome as well as for patients with coronoid disease and only grade 2-3 chondromalasia. In this particular patients we perform a PAUL to get pressure away from the coronoid and try to stop the cartilage reduction.
The idea behind this surgery is to shift the weight baring part to the radius by abducting the proximal Ulna and drop the tip of the coronoid down, additionally.
You achieve this with an Ulna cut and pressure through the special designed plate.
With this surgery, you open the collapsed medial joint space. In second look arthroscopies new, fibrous cartilage.
We do this surgery on a routine base in dog older than 12 mth with coronoid disease and cartilage damage grade 2-3 and in dogs with MCD.
The dogs are doing very well after recovery. But.. the recovery phase is a long period.
We see severe lameness up to 6 month post op. The reason is first the ulna cut and second the underling disease process. It takes time to build fibrous cartilage.
Often the patients are quite good and the owner doesn't take enough care and the dog runs or jumps and gets a painful / lame. In this cases you have give these guys a rest period.
Rehab Plan we do
0 -2 week: joint mobs, PROM, RICE, weight shifting
2-4 week. Joint mobs, PROM, Rice, Isometric work.
4-8 : ads under water treadmill, Balance disc
8-12: add cavaletti
-6 moth add restrictions to the owner. We try to strengthen and start in the last 2-3 month with AROM work.
My idea is first cartilage development then joint movement. My concern is a acute on chronic onset of arthritis during the healing process
Hope that helps.
Looking forward to discuss with you Rehab of this guys.
Gereon
Dr.Gereon Viefhues CCRT
Certified Canine Rehabilitation Therapist
FTA für Chirurgie, FTA für Kleintiere
ZB Augenheilkunde, Zahnheilkunde,
Röntgenologie und Sonografie
LAURIE EDGE-HUGHES