Meet Brandy – our December 2016 Pet of the Month. We met Brandy at the end of April 2016 for evaluation of rear limb weakness issues over the prior month. She is a 13 year old, spayed female, German Shepard mix dog, who had a history of arthritis in her spine, which was noted on x-rays in 2013, and her stifles (knees) too, which was found early that month. She had been slowing down and a visit to her veterinary office revealed that she had pain on palpation of her T-L junction (thoracic-lumbar region aka mid-back region), stifles and hips. She also was slow to correct her rear paw placement when that was tested in her neurologic assessment.
Brandy’s initial physical examination at Pawsitive Steps Rehab revealed hind limb incoordination bilaterally (R>L) with some neurologic deficits also noted. Additionally, moderate myofascial back pain, muscle atrophy and arthritis in multiple joints (both carpal joints/wrists, elbows, stifles/knees, hocks/ankles, hips and also all front paw toes).
Brandy’s rehabilitation plan was set up to take her arthritis and neurologic issues into consideration by focusing on gentle, low impact exercises to strength muscles without straining her arthritic joints and also to improve her overall balance, body awareness and proprioception
At her reassessment visit (about 1 month after starting rehab), Brandy was doing quite well and was taking walks again at home. She was able to rise from sits and downs much easier and her endurance had also improved quite a bit. Her follow-up measurements showed that she had gained muscle mass in both rear limbs and her weight distribution between all of her legs was more evenly distributed. Her family was thrilled with her progress and so were we. Her session frequency was decreased with the plan to do more homework exercises and less overall time at the office.
Unfortunately, Brandy experienced a set-back in late June and experienced some back pain along with more difficulty with her rear legs again. Her rehab sessions became focused on pain management with minimal exercise as a result. Her discomfort stabilized, but her rear limb function did not rebound as quickly as we had hoped. As a result, her family took her for a consultation with a neurologist. Brandy had an MRI performed with the hopes of obtaining a definitive diagnosis. That MRI revealed that Brandy had multiple intervertebral disc extrusions, in fact, there were 6 protruding discs and most of them appeared to be chronic. The neurologist suspected that one of these, located just behind her shoulders, was the cause of her current issues.
So what does this all mean? Brandy’s MRI findings actually suggest that she had probably had low grade back issues intermittently throughout her life, but apparently had not really shown many outward signs of problems. Surprisingly, it is not an unusual for pets to hide pain from us. However, this summer, she has one area in her spinal cord mid-way over her ribs in which disc movement was creating discomfort that she couldn’t hide anymore. Although the disc had not moved much and was not in danger of causing paralysis, it had triggered local inflammation pressing on her spinal cord, which was resulting in decreased nerve signals to her rear legs and some coordination issues that were obvious. In Brandy’s case, knowing exactly what the underlying problem has helped to modify her treatment plan to be more effective. Acupuncture was added to her therapy regimen and gentle structured exercises were resumed and Brandy has been doing quite well again since then.