Doods - Return to Agility Competition, Post-op TPLO Rehab

Case Report: Doods – Return to Agility Competition
Written by: Ashley Tewilliager
University of Missouri
College of Veterinary Medicine Class of 2016

Patient name: Doods
Signalment: 8 year old, female spayed, Pembroke Welsh Corgi


Clinical Problems:

  • History of hip dysplasia
  • History of bilateral hind limb weakness. Suspect DM vs polyneuropathy vs hind limb neuropathy vs IVDD (intervertebral disc disease)
  • Bilateral carpal valgus conformation (8 degrees)
  • Weak core musculature
  • Bilateral thigh atrophy (left more than the right)
  • History of homozygous testing for DM (degenerative myelopathy)
  • Left TPLO (tibial plateau leveling osteotomy) surgery on 10/6/14
  • Myofascial trigger points on left thigh muscles
  • Moderate myofascial back pain from T8-L5

Rehabilitation goals:

  • Strengthen core musculature
  • Strengthen thigh, hip, and quadriceps musculature
  • Reduce the tight muscles in left cranial thigh
  • Improve balance, proprioception and coordination
  • Reduce myofascial back pain
  • Prepare Doods to return to the sport of agility (by March 2015)


Modalities used in rehabilitation program:

  • Homework exercises:  Cookie side bends and stretches, sit to stands (squats) on the floor and on a balance disc, short slow leash walks, rotation around a balance disc (both directions), square sits on a platform, 3 leg and diagonal standing, cavalettis, short sequences on low agility equipment, low jumps
  • Massage
  • Dry Needling of the Left thigh muscles - Releases the tension in the muscles, allowing them to relax
  • Underwater Treadmill - Increases resistance of moving limb through the water while also decreasing the weight placed on the joints.
  • Aroma Therapy
  • Cold Laser Therapy - Class IV laser was applied to left stifle, right stifle and hip as well as the lumbar back.  The laser promotes tissue healing by increasing blood flow to treated areas as well as by reducing inflammation
  • Therapeutic Floor Exercises - 3 phase approach to recovery
    • Phase 1: Early post-op – bone healing and reverse of muscle atrophy
    • Phase 2: Muscle building , core strength, and body awareness using a variety of stability and balance equipment
    • Phase 3: Exercises designed to return to sport.  Developed plans for home practice with agility courses allowing for gradual increase in difficulty.


Assessment:

Doods came to Pawsitive Steps Rehabilitation and Therapy as the #1 ranked AKC agility corgi, who was having some problems with hitting jumps with her rear legs as well as some other hind limb issues (including limping occasionally). Doods was found to have multiple issues that could be causing these problems (see clinical problems list above).

Two weeks after having TPLO surgery (in October), Doods began rehabilitation therapy sessions twice weekly. These sessions helped her to improve her overall strength and use of the affected leg. The sessions also helped relieve the tight muscles and myofascial back pain.

Doods did very well with her exercises at home and during her therapy sessions. This allowed the staff at Pawsitive Steps to use new exercises to continue to challenge Doods as she got stronger and mastered each exercise.

At the beginning of December, Doods’ osteotomy (the cut into the bone for the TPLO) surgery site had completely healed as assessed by x-rays and she switched from rehabilitation appointments to fitness appointments, with the goal of returning to agility competition in March 2015.

 

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