Coco Channel Case Report – Rear Limb Amputation

By: Jamie Clapper

Michigan State University

College of Veterinary Medicine Class of 2015

 

Patient Name: Coco Channel

Signalment:   7 year old female spayed Mastiff Mix

Clinical problems:

  • Diagnosed with primary bone tumor, suspected osteosarcoma, in her left tibia.
  • Left hind limb was amputated
    • Her left hip also had severe hip dysplasia—it was elected to remove the limb rather than fit for an orthotic
  • She is having trouble ambulating at home after the amputation.
  • Coco is also undergoing chemotherapy

Rehabilitation goals

  • Strengthen and build her muscle in her right rear limb to help take strain off the front limbs
  • Teach her to ambulate better and learn to maneuver on 3 limbs

Modalities used in rehab:

  • Initial examination (2/11/14)
    • Gait analysis—took videos and observed  how she maneuvered around the practice
    • Stance analyzer—to assess which limbs are bearing the most weight after the amputation
      • Results revealed that the right front limb was bearing most of the weight
    • Goniometry of her joints on all other limbs
  • Therapeutic floor exercises used in additional rehab sessions
    • Uneven surfaces
    • Staggered cavelettis
    • Figure eights
    • Back Stretch on egg—targets thigh muscles without bearing the full body weight
    • Trampoline exercises
    • “Rocky road” exercises
  • Underwater treadmill
    • Provides resistance training and releases weight off the joints to build muscle mass
  • Acupuncture
    • Neurologic stimulation and connection in the body by needling specific points
  • Cold laser therapy
    • Class IV laser used on affected areas (back and left hip area) to increase blood flow, promote healing, and relieve pain.
  • Homework exercises
    • Cavelettis, Uneven surfaces, Figure eights, Cookie stretches, side bends and massages
    • Homework exercises were used to help strengthen her right hind limb and core starting with a few reps at a time and slowly increasing to more reps and more exercises after each visit.  

Assessment

  • Following Coco’s initial exam, she was still having difficulty at home walking on the wood floors and seemed to be dropping her right hip due to weakness from overuse of the muscles.
  • At Coco’s first rehab appointment she was reluctant to walk in the treadmill, however she ended up walking better towards the end of the visit.
  • At Coco’s second rehab appointment she seemed much more comfortable in the underwater treadmill and her right hip seemed to drop less
  • At Coco’s third rehab appointment her right thigh measurement was increased  1.5 cm. She is adequately increasing the muscle mass of her right thigh. She experienced less hip drop in the underwater treadmill and seemed more balanced on her three legs.
  • At Coco’s fourth rehab appointment she seemed very happy and she was doing well. She was going to have her second chemo therapy treatment later in the afternoon on that day. Coco seemed very comfortable doing her exercises and walking in the underwater treadmill.

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