Spot - Orthotic Device for R Cruciate Tear

Spot’s Case Report- Right Stifle Orthotic

Written By: Jessica Howe

Michigan State University

College of Veterinary Medicine Class of 2015

1. Patient Name: Spot
2. Signalment: 6 year old, Male Neutered, Siberian Husky
3. Clinical Problems:
   1. Complete right cranial cruciate tear
   2. Moderate to severe myofascial back pain T5-S1
   3. Muscle tension/pain in the quadriceps and sartious (right side greater than left)
   4. Evidence of degenerative joint disease in multiple joints (including the hocks, stifles and toes). 
   5. Decreased extension in both hips
   6. History of hypothyroidism
   7. Borderline carpal hyperextension
   8. Overweight
4. Rehabilitation Goals
   1. Relieve right stifle discomfort and provide support via the orthotic device
   2. Strengthen core, thigh and hip muscles
   3. Improve flexion and quality of movement
   4. Improve function, gait and activity
   5. Promote weight loss
5. Modalities used in rehabilitation program:
   1. Therapeutic exercises:
      1. Low cavalettis (2 inches high, ran 4 times)- this increases leg lift, thigh strength and body awareness.
      2. Uneven surfaces to walk over (2 times)- this is a good exercise to work the core muscles. 
      3. Weight shifting with elevated front limbs (10-15 second intervals)- this shifts more of Spot’s weight to his rear limbs, increasing the difficulty to activate his thigh muscles. 
   2. Underwater treadmill: Water level was between his shoulder and elbow to decrease impact on joints. During his first time in the treadmill he walked for 3 minutes at 0.6 mph. 
   3. Laser Therapy: Class IV laser therapy (both stifle joints, thoracic and lumbar spine) helps to decrease inflammation, promotes blood flow and tissue healing.
   4. Therapeutic massage
   5. Homework
      1. Cavalettis (10 repetitions twice daily)- this increases leg lift, thigh strength and body awareness.
      2. Uneven surfaces (5-10 passes twice daily)-  this is a good exercise to work to the core muscles, because Spot has to use those muscle to stabilize himself as he goes over the different surfaces.
      3. Sit proper- this retrains Spot’s muscles in a proper sit, and when he stands from a square sit he strengthen his quadriceps.
      4. Weight shifting with elevated front limbs (5-10 second intervals)- this shifts more of Spot’s weight to his rear limbs, increasing the difficulty to activate his thigh muscles. 
      5. Figure 8’s (5 laps twice daily)
      6. Short leash walks (5 minute walks 2 times daily)
6. Assessment
   1. First visit after getting the orthotic device
      1. Spot is doing well at home, and enjoys walking in his device
         1. Use to “donkey kick” often when the device was first put on his leg, but now he doesn’t do it as much.
         2. Walks about 500 feet 2 times a day.
         3. Does not have trouble using the stairs to get into the house. 
      2. Spot lost 1.4 lbs since his initial appointment.
      3. Spot’s stifle is stable and he is walking well with the orthotic device from OrthoPets. 
      4. Myofascial pain located in the lumbar back
   2. Second visit after getting the orthotic device
      1. Spot’s owner increased the length of time that Spot wears his device to 4 hours at a time. 
         1. After 3 hours Spot will start to kick his rear leg back to get the orthotic off his leg. 
         2. His owner noticed that he was limping with it once she increased the wear time.
      2. Spot’s orthosis continues to stabilize his stifle by preventing cranial tibial thrust. 
      3. The orthotic device appeared to be slipping down Spot’s leg, this could be causing the discomfort with the increased wear time. 
         1. Videos and photos were taken of Spot in his orthotic device
         2. Spot’s orthosis was sent to OrthoPets to be readjusted to fit Spot more comfortably – not unusual to need a minor adjustment in order to perfect comfort and fit.  Looking forward to getting his device back and re-assess at his next rehab visit.

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