An ACL tear and TPLO journal

[Sue R]

I find it quite difficult to get a good side-on view of Celt in the treadmill. Because he wants to turn his head to watch me, even just a little bit, it puts him off being straight. Hopefully, at the next appointment, we might be able to get help so we can get a really good, perpendicular video of his treadmill walking.

 

Meanwhile, the treadmill walking *makes* him use his leg, *makes* him push off on that foot, *makes* him extend his leg both backward and forward. What Shari and I both noticed on his way out after his appointment was that he was thrusting more with his bad leg just in walking. One thought Shari had was that since Celt has been favoring that leg for quite some time now (probably since as long ago as January or February, or maybe even longer), he's also got muscle memory to contend with - or the "habit" of compensating for that leg.

 

We also see this when he is standing - he does not stand "square" and he absolutely can stand square right now, but he's spent such a long time toe-touching (standing flat on his other hind foot, but standing with this hind leg extended slightly back so that he is bearing weight only on the front of the two middle toes and not on the rest of the foot), that it's ingrained and will have to be "unlearned" in his muscle memory. And, until this becomes his default in walking and standing, he will be unbalanced as he compensates, and that will cause back pain (which he is experiencing to a certain degree now) along with putting stress on other limbs and joints.

 

I'm finding his feet fascinating as a barometer of what he is doing with his legs. Previous photos here have clearly shown how he was using the foot on his good leg but not the foot on his bad leg for most of his support - pad swelling and lack of pad wear made it easy to see the difference between the use of the two feet (and, therefore, legs).

 

In addition, watching the wear on his toenails has also been an indicator of which toes he is using and also how he is using his legs. For my dogs, normally, I find that the two outer toenails exhibit less to trim than the two inner toenails, apparently doing more of the "traction" than the inner toes in normal, everyday walking and running. But, on Celt's bad leg, the two inner toenails (because he's been defaulting to short strides, extending that leg back at rest, and toe-touching at rest) are showing more wear than the outer toenails. I have a good benchmark as I trimmed all his nails just a couple of days prior to his surgery.

 

A trained professional like Shari can see these little "periforal" signs and, if I know what to look for, I can see them, too. Foot pads and toenail wear are a good indicator of leg use that I can observe in the future to help me keep track of his progress.

 

I will try to get more useful photos and videos taken and posted but a week's visit of two grandchildren has kept me busy with other things recently! And that's been a very good thing!

[Sue R]

One more reference to the use of the feet and the underwater treadmill - if you look very closely at the first, head-on underwater treadmill video that I posted (at his second therapy session) and the most recent head-on underwater treadmill video that I just posted yesterday, you can see a difference in the appearance of his hind feet in both, but the difference is more noticeable in the first video.

 

Essentially, what is happening is that in the first video, he is bearing less weight on his bad leg and therefore the toes on his feet are not splaying out as much as the toes on his good leg. In addition, his stride is shorter both in front and in back.

 

In the latest video, you can see more splaying of his toes on the bad foot, so that it almost resembles the splaying on the good foot. Splaying may be the wrong word as they are not really splaying - in a bad way - but spreading out as they bear the weight and provide traction.

 

It's a subtle difference but it is a visible difference and a sign of improved use of the leg, as reflected in the appearance of the foot in action.

 

One change I have made to our routine - the three-legged dog has been our least favorite exercise. It's been hard on Celt as it's quite demanding, and it's not very comfortable for me, either. He has had a real tendancy to either lean his weight on the good leg that I have held up, so that he is not bearing the weight he should on the bad leg (kind of like using my support as a crutch). We could see this happening as he would adjust his bad leg's position while he was supposed to be standing on it, and I could feel it in my arm that was holding up and supporting his good leg.

 

Last week, Shari showed me to shift his weight so that it would be centered over the bad leg to avoid this problem, but I found my results to be mixed - I could do it successfully about half the time. Now Shari tends to switch from one side (or one exercise in ROM) to another with each rep. I do all the reps of one ROM exercise, then all the reps of the next, because that's how I started doing it and (more importantly) because doing it that way is much easier on my back. And Shari said that it was not an issue to do it that way since he is lying down and not having to bear weight for any extended time on a limb.

 

Last night and this morning, I did alternate the legs on the three-legged dog exercise, and found a huge improvement all around - I can shift Celt's weight to where I need it more easily and I am not overtiring his bad leg by doing multiple reps on that side. Last night, he did not feel the need to shift that leg until the ninth rep, and this morning, until the tenth. That tells me that he is handling the weight better with my doing the exercise in this manner.

 

I had been putting his foot down for a very brief rest between each rep when I did all the reps on one side and then all on the other, but this allows the leg not only a longer, significant rest but also a good flex during that rest. And that resulted in a much more comfortable dog (and person) who could do the exercise more correctly and more comfortably.

 

Meanwhile, he's loving the sit/stand exercise because that is the last one - and there are treats! I put twelve little bits in my hand (Celt is very food motivated) and he is beside himself with eagerness to get it right and get his treats. And so we finish off each session (now running about 45 minutes for walk plus exercises) with something very positive in his mind, and leaving him tired but happy.

 

I would love to have more photos but until I can get Ed to be available to help document, I'm afraid that narrative is going to be all I can do. I hope to get some good photos at Shari's on Saturday, too. I think it is so much easier to *see* rather than to *read* what is happening.

[Sue R]

Here are just two videos that I was able to get today. The first shows Celt walking, viewed from the side. Notice that the extension both forwards and backwards on the injured leg (his right leg) is very similar to that of the left leg. (Sorry for the start of the video, but Ed was trying to tell me to walk with hand signals because Dan was trying to do everything Ed was telling me to do, and you can see him at the end, walking along by Celt.)

 

 

Here is Celt walking as seen from the rear. As you watch, you can see that his right hind leg is extending back just about as far as the left hind leg. His stride has really improved recently. I think that, if you could not distinguish the two legs because the hair has not yet grown in on the leg where surgery was performed, it would be difficult to know which leg had been the injured one at a walk - at a stand, he still defaults to holding that leg further back and relying on the toes rather than the whole pad to stand.

 

And, again, I forgot that I can't rotate the camera so this video is on its side, but you can still see the way he is using his leg adequately.

 

[Sue R]

And a photo taken today that shows his foot pads - while it is still obvious that the right foot pad is not bearing weight as evenly and regularly as the left foot pad, the wear pattern shows that he is working that leg more normally at this point.

 

The right foot and toe pads look a little bit puffier than the left foot and toe pads but I think a bit of that is accentuated as I had trouble holding them evenly and the right foot is just a smidgeon closer to the camera.

 

 

Comparing this to previous photos, I can see quite a difference in the wear pattern since he began his therapy and exercise.

[Sue R]

August 4 2012 - 5 1/2 weeks post-op and 4 weeks of therapy completed

 

Just an observation or two before talking about this week's therapy visit - Celt has been walking quite well. I notice that he's really beginning to stride strongly and more quickly on the walk up the hill (the first five minutes or about 800' of our walk is up the road). His pace is much more variable during the next five minutes, which is a very gentle downslope on the neighbors' driveway. The next five minutes, back up the very gentle upslope returning to the road, he again tends to set a variable pace. But coming home down the road, he usually moves more slowly.

 

He should be walking, not trotting, so I try to let him set the pace that will keep him walking because if I set a pace and it's faster than the pace he wants to set, he will wind up alternating walking and trotting. Shari has told me that while trotting at this stage will do him absolutely no harm, it won't be as beneficial as walking. Walking results in more weight-bearing, a longer period of weight-bearing for each stride, and less opportunity to "cheat" with regards to using the leg properly.

 

I wondered about the slow downhill pace, remembering that when my paint gelding, Blaze, got older, he would be very slow or even reluctant to move out going on a downslope (and this is WV, where almost everything has a slope). He was very posty-legged (he'd been a pricey horse as a youngster, flashy and having a very four-square build which was popular, but which did not lead to flexibility and soundness over time. I wondered if I was seeing something similar in Celt, a bit of discomfort in the stifle, leading to him moving more slowly downhill. And Shari confirmed that, yes, going downhill is demanding on the stifle and I shouldn't be surprised to see some of this at this point in his recovery.

[Sue R]

I have to say that while each visit has been very largely positive so far, I was very happy to hear what Shari had to say about her observations about Celt this visit. And, with his follow-up with the surgeon scheduled for this coming Wednesday, I was particularly pleased.

 

Shari, as always, took a little time to observe Celt walking around, watching him from the rear as well as from the side (or whatever angle he gave her). She was pleased with his walking, finding his gait to be pretty even and his use of his leg to look fairly normal.

 

She did the cold laser and ROM exercises. At this point, his ROM is quite good on both sides, very similar except for the fact that since the joint angle has been changed by the surgery, the one side will never be *exactly* like the other. But, if his hair was grown back in, anyone but a professional would be hard put to tell which leg had had surgery by the ROM. All four legs are able to be manipulated pretty much to the maximum at this point, quite an advance from his first session.

 

Here he is, suffering at her hands as she applies the cold laser to his back (good news there as the back pain that has been evident to her in prior weeks is no longer obvious, another sign that he is compensating much less for his bad leg) -

 

 

He's also showing a lot of what I'd call "feeling good" behavior when she does the cold laser and ROM (which he is also doing at home). He's rolling on his back, wiggling, just acting like he is feeling *good*. We both think it's a good sign - and I do think he does it a bit to delay the ROM because that is work, after all.

 

His next exercise was the three-legged dog, and Shari felt that there was definite improvement there in terms of his bad leg being stronger and more able to bear weight comfortably. This has always been our least favorite exercise but one of great importance, and one that needs to be done with care to be done right.

 

For his walking backwards exercise, Shari pointed out that I needed to make sure that he was doing that in a straight line. I know that at home, if there is a distraction of any sort, our line tends to be rather like a worm track, all over the place. And not going straight allows him to shortchange his stride on the bad leg, and so I need to be certain to make the lines as straight as possible. When I do, his backward stride is improving, she pointed out.

[Sue R]

We moved on to the cavaletti, where he did very well at the 8" height, stepping over readily and easily with either hind leg leading, but where he showed us he is still not quite ready to graduate to the 10" height yet.

 

On to the stairs - he did the baby (half-height) steps with ease, and went on to do the full height (7") steps correctly each time, unless he got excited or goofy, and then he would hop. But he did them well enough, both up and down, when he was not getting excited that Shari added steps to his daily routine. We have steps to the basement, covered with old poly-turf, ten of them that are about 8" tall (nothing in this house is square or even or the same, including these steps). One trip down and up twice a day has been added to our repertoire at home, and he is doing them well so far. The nice thing is that he is not prone to going down to the basement and so he walks down there (and back up again) with me nice and slowly, with no hopping. As soon as we get in from our walk, we head straight to do this new exercise.

 

Now his new, favorite exercise at home is the sit/stand. Maybe because it's the last exercise we do or, more likely, because it's the only exercise that involves *treats*. And he can do it while the other dogs look longingly from the other side of the baby gate - sweet! He got to demonstrate his prowess at this for Shari as I directly him and doled out the treats, and she was again quite pleased to see that he was doing this exercise well and correctly.

[Sue R]

And guess what's next! His favorite, during the fill-up -

 

 

Shari upped his time for each of the three sessions to three minutes, and we both noticed something new - the first time very in the treadmill, he would try and "cheat" by putting both his front paws on the stationary bar at the front, which is common for dogs new to the device. Once he got the hang of it, he would not do that. Last week, his fourth therapy visit, one of his front feet hit the bar once or twice and he immediately got it off - you could see it was not intentional.

 

Well, during his first session this time, he hit that bar several times. Shari noted that his strides were shorter and he wasn't striding out. She said it was time to increase the speed a bit. This was a very good sign, because these were indicators that he is becoming stronger; his stride is stronger, longer, and faster; and he is making significant progress. So, for the second and third sessions, the speed was increased and he no longer hit the bar and was able to take the longer strides that were more comfortable and natural to him.

 

 

I can remember how tired he would get the first couple of weeks on the treadmill - walking through that water is hard work. Each week, his stride has gotten stronger, longer, and more confident, and his stamina has increased. This week, in spite of longer sessions and a faster rate of treadmill speed, he finished looking like he was ready to do it all over again - none of the tired look we'd seen in the earlier sessions.

 

Because of his progess and his improved stamina, Shari said we could up his walks to 25 minutes twice a day and, when I can, add another 10 minute walk (up the hill and back again) during the day.

 

I took the opportunity to pace off the walks we've been taking and we do it by distance rather than exact time, but it figures out to about 800' for every five minutes (400 of my steps at about 2' per step). That's about 0.15 mile for each five minutes. Even though we are not walking for a long time each time out, it adds up. A 20-minute walk is about 6/10 of a mile.

[Sue R]

Celt is now loose in the house most of the time when there is someone to keep an eye on him. If not, he is in the crate/xpen. Outside, he is always on the leash to avoid an "explosive" movements (the value of this has been demonstrated twice this last week when the other dogs saw and pursued woodchucks at the neighbors' farm - while Celt is not a chaser, if he had been off-lead, he probably would have responded with a fast take-off, and avoiding this sort of thing is wise at this point).

 

Here is our fifth-week routine for our at-home work, done twice a day -

 

25 minutes of walking (about 3/4 mile) on leash and with varying slopes

 

10 steps down and back up on the stairs

 

ROM exercises for all four legs, six reps each exercise, holding to a count of eight

 

three-legged dog exercise (for both hind legs), 10 reps, holding to a count of eight

 

walking backwards about a total of 12 to 15'

 

stepping over an 8" cavaletti 12 times (letting the leading leg vary as it does naturally)

 

sit/down exercise, six reps, don't forget the treats!

 

(and add a 10-minute walk during the day if able)

[Sue R]

I realized I'd miscalculated on estimating Celt's walk distances - I was measuring my steps from heel to toe instead of heel to heel, so I've had to estimate down from my original calculation of about 800' for every five minutes, to 600' for every five minutes. At current walks (2 25-minutes and 1 10-minute at day), that's about 7200' or about 1 1/3 miles total per day. I'd been calculating wrong at about 1 4/5 miles total. Bummer. But only the calculation was wrong, the walks are still right. One fourth the distance f is still at a good, fairly challenging upgrade (and then one-fourth back down) and one fourth each up and down a varying but usually gentle grade.

 

Still, we've been increasing each week from a start of 20 minutes total a day, adding 10 minutes a day - until this week, where we added another five minutes to each of his walks, and another 10 minute bedtime walk (on the hill). I'm watching closely to see if this is overdoing it or not. So far, he seems fine with it and Shari will let me know on Saturday if she thinks it's pushing him too hard.

[Sue R]

I've probably neglected to express my appreciation to Dr Jesse Fallon of Cheat Lake Animal Hospital. He is the vet who diagnosed this issue over three years ago, even though the ortho specialist that we saw for the second opinion felt that surgery was not the best option at that time and chose a conservative, rest and medication treatment, which worked enough for Celt to remain sound for several more years.

 

And it was Dr Fallon's description to me about what to look for in Celt that allowed me to realize that the problem recurred this winter because he was not showing obvious signs of lameness, just mainly the toe-touching when he stood. He was running, jumping, and acting normally otherwise except for just a couple of times when he limped for a few steps or held his leg up for a few steps.

 

Celt had a totally torn ACL, and yet walked and ran apparently normally - yet, due to instability in the knee, arthritic changes were occurring (which were only visible on xray). I have seen video of dogs in whom this was not treated, and they can become very challenged to walk and function normally.

 

If it hadn't been for Dr Fallon, I might have just thought he'd tweaked something and that he'd always have a propensity to get a little stiff and sore in that leg, but that it was nothing to worry about and probably nothing could be done. But that could have led to a catastropic injury if more damage had been done, painful arthritis in any case, and the end of the sort of active life that Celt has loved to live.

[Sue R]

August 8 2012 - seven weeks and a day post-op and 4 1/2 weeks of therapy

 

Good news at the surgeon's office - the bone has healed so that part of worry is behind us, and he is "right where the vet likes to see them at this point". That's what he's said previously and not the glowing testimonial to my devoted care that I was hoping to hear! But good news, nonetheless. I don't think the vet gets into much other than his area of expertise - surgery. But I was glad to see him walk quite soundly into the office and around and about, quite a change from the last visit where I was still using the sling to avoid issues and where he was favoring his leg noticeably.

 

I was concerned about something, though, and I called Shari about it. In previous weeks, when we increased his walking, we added five minutes to each of the two walks. This week, we added those five minutes each plus an additional 10-minute walk plus a trip up and down the stairs twice a day (8" steps, 10 of them, and pretty steep). Celt did wonderfully on the new routine on Sunday and Monday, and even Tuesday morning. But last night and this morning, I noticed him not doing the stairs so well, starting out with hopping and then switching to stepping only when I stopped him and restarted him with a caution to "walk". And I saw him standing once with his bad leg just trembling, which I have never seen before.

 

In talking to Shari about my concerns that we were over-doing it and over-tiring the leg, she immediately told me to tone it down a notch - making it two 20-minute walks and one ten-minute walk each day, and dropping the stair exercise for the rest of the week. Then, if he shows more strength in his leg at Saturday's visit, we can either add five minutes to each walk and/or add steps, depending on what he shows her in the treadmill and on the stairs there.

 

I guess we got a bit overconfident with his progress. And maybe I'm worried about nothing, but I'd rather be safe than sorry. If he had not been on crate rest so long prior to surgery, I think he would be making more progress, but we are having to build him back up from a state of being unfit as well as having had surgery.

 

So, today's report card was an A for surgical site healing and a B- for overall conditioning progress. Considering how well he has done and the lack of any significant setbacks, I have to say I'm happy in general with his progress.

[Sue R]

Well, a combination of things this evening (getting home later than I expected, thunder looming on the horizon, Celt just not seeming really comfy with things) led me to cut back hard for just the evening - only a ten-minute walk (which he had no problem with, and which would have been 20 minutes if the thunder wasn't threatening).

 

With the short walk, I gave him a try on the stairs, just to see if being tired from an expanded walk might have made the difference this morning and yesterday evening - and being very careful to regulate his speed to a walking pace. He did one down and up very well again, just like he'd done earlier in the week.

 

I did his ROM but he seemed a bit fussy so I'm wondering if he's a little sore somewhere. Then when he seemed very uncomfy at the first couple of reps of the three-legged dog (which is probably the most challenging exercise for his leg other than maybe the stairs), I decided that maybe *he* needed a night of rest, and just did the cavaletti (which he did easily) and called it quits.

 

I'm considering taking just him out for another ten-minute walk just so we aren't slacking too much and hoping that an easy evening might just be what he needs to recoup for tomorrow. Too bad he can't tell me how he feels because I'm not sure if I'm interpreting how he acts correctly but I just get the feeling he needed a little slack time. I'm just so afraid to slack off even once because I am a slacker at heart, and don't want to head down that slippery slope.

[Sue R]

Maybe going easy last evening was the right thing - Celt was eager to walk and relaxed for his exercises, and all went well. Since I don't think I'll get in a ten-minute walk today, we did 25, no stairs, everything else the same as usual.

 

As someone else mentioned, his exam by the ortho vet yesterday could have left him a little sore as the vet carefully checked his joint, so that might have been part of our problem last evening, with him seeming so uncomfy for his exercises.

[urge to herd]

When I've recovered from any real physical trauma, (broken bones, surgeries, severe illness, etc) I've noticed a couple things.

1) I seem to recover about 70-80% in the first several weeks, and then that last 20% or so takes several months!

2) Stamina takes a long, long time to build back up. Like, I can't just finish these dishes/this report/etc, I need to rest NOW. And when I've pushed through, I'd regret it for a few days.

3) Recovery isn't a straight line upwards. It has its peaks and valleys. Particularly in the first few months, if I even had emotional stress my energy level would plummet for a while.

 

Hope the above observations are helpful. Celt's progress reports seem great to me, and you've done a tremendous job as his therapist!

 

Ruth and Agent Gibbs

[Sue R]

You are so right, Ruth - and I have to keep reminding myself of these things that you mention!

[Sue R]

August 11 2012 - 7 1/2 weeks post-op and five weeks of therapy completed

 

I have to say that in observing Celt the last few days, that he simply had been over-challenged by the increases in his work starting last Saturday. Therapy day is pretty exhausting, with exercises, new exercises, and the treadmill. By Tuesday evening, he was just not bouncing back after each day's work. Wednesday's visit to the surgeon was not tiring but probably produced some soreness in his leg as the surgeon manipulated and evaluated it.

 

Taking Wednesday evening mostly "off" was probably a very good thing for him as by Thursday morning, he seemed back to his old self. However, under Shari's advice, I cut back his walks by 10 minutes total (either doing two 25-minute walks or two 25-minutes and one 10 minute walk each day), and eliminated the stair work for a few sessions, as that is very taxing.

 

So I was pretty eager to find out how Shari felt he was doing by Saturday morning at his sixth therapy session. We started out, as always, with Shari observing him walking around and the smile on her face told me that she was pleased with his gait. And then it was on to the cold laser and ROM exercises. I took photos again this time so I could compare them with the ROM photos I'd taken at his first session, and it's easy to see that a lot of progress has been made. His range of motion in all positions has increased noticeably and is pretty much at the maximum expected for a healthy, sound dog.

 

Each one is shown with his first visit followed by this sixth visit.

 

Here is his hind leg flexion (which keeps the hock joint supple as well as the stifle joint) -

 

 

[Sue R]

And his hind leg forward extension -

 

 

 

And hind leg backward extension -

 

 

[Sue R]

His front leg forward extension -

 

 

 

And front leg backward extension -

 

 

[Sue R]

The three-legged dog was next and Celt showed enough improvement that Shari demonstrated our new exercise. Now, she calls it the cross-legged exercise (since the diagonal legs are lifted) but I keep forgetting that name and think of it as the two-diagonal-legged dog. It is very challenging and Celt did it very well the first two times but the third time (when this picture was taken) he was tiring and was "sinking" a bit on his hind leg.

 

 

I'm going to have to call her and get some advice because I can't seem to get that hind leg (the good leg) into the same position as she does, in a bit of rearward extension. I can get it folding up like we do on the three-legged dog (and the first of his ROM exercises) but while I try to ease it on back as in the photo, Celt pulls it forward into the flexed position. Since the exercise is very taxing on his healing leg, I'm not trying to "fight" this other leg into position, and need to get her advice on what I might be doing incorrectly so that I don't get the right position.

 

We did the backwards-walking exercise again. Celt is not really reaching back with his hind legs but he is not shuffling as he did the first week. Again, I have to remember that I need to keep him going back straight for the maximum benefit in this exercise or he can cheat by curving and favoring the bad leg.

 

The cavaletti went well as he can easily step over the 8" but as in the last couple of visits, he was not getting over the 10" properly. So I proposed to try a 9" height at home by putting a thick book under each cone, and that has gone well. I can see him having to lift his legs with a bit more effort but he does step over the 9" and not hop like he was doing with the 10" at the visit. Once he's doing 9" casually, then it might be time to try 10" again.

 

He did his best time on the stairs this week, showing that he could do it quite consistently and well, and so we will be doing that again this week in our at-home exercises.

[Sue R]

A couple of gratuitous photos prior to the treadmill, since he likes it so much and is always eager to get into the tank. And since most of my photos/videos feature a "headless" Shari, I wanted to get a photo or two showing that she does indeed have a head!

 

Watching for the water -

 

 

And wanting to make sure I see him when the water's rising -

 

 

He's still not bringing that bad leg as far forward as the good leg in each stride but his stepping is improving each week in smoothness, evenness, length, and stamina. It's hard to get a good video from the side because he keeps his eyes on me and where his eyes go, his head goes, and where his head goes, his body goes - and so he's not striding as straightly and well when I try to video. (And, since I messed up so badly last week with the tripod, I left it in the car this time.) Shari increased his time to 3 1/4 minutes per session at the faster speed that she used last week but, with all the work he had done, he was tiring by the third session and she ended that at three minutes.

 

A short video from the side -

 

[Sue R]

Here's another gratuitous photo, just showing the one end of the bright and open room where Shari does her magic. There are a number of items of equipment that we don't use with Celt that are not in the photo, but it is a very well-equiped facility. You can see how Shari is in the tank in case Celt needs support or encouragement, and she has a mirror placed so that she can observe his leg movements at all times.

 

 

Our daily at-home exercise routine this week is -

 

either two 25-minute or two 20-minute and one 10-minute walks

 

one trip down and up the basement stairs (10 steps) after each walk

 

the ROM exercises on all four legs, 6 reps each to the count of eight

 

only five reps of the three-legged dog to the count of eight

 

a minimum of two and maximum of three reps of the cross-legged dog to the count of eight (starting with two and progressing to no more than three as Celt shows he is capable of doing this)

 

walking backwards about 12-15', nice and straight

 

12 steps over the cavaletti set at 9" high (if he can't do 9", back to 8", but he has been showing me that 9" is not a problem)

 

six reps of his sit/stand exercise (complete with treats, so it's his favorite other than the walks!)

 

Each week we do a little more or a little longer or a little more challenging, or a combination of the above - always being careful to not overdo but yet not to be content and get stuck in a routine that is comfortable but not producing progress in terms of strengthening, promoting flexibility, balance, and symmetry.

[chi chi pup]

Hi Sue,

I have to say this is great info. My lab mix had the tradtional surgery last July and we did alot of the same things you are doing, except we did swimming instead of the underwater treadmill.

I had a physical therapist come to the house to show me the exercises and for deep tissue massage which he still gets. She also got him swimming as he never had swam before. He is now in better shape than he was before.

The info about the feet and toenails is great, most people wouldn't even think of that, and I always wondered why the two middle toenails grew the fastest.

I also belong to ortho-dogs, you should post this recovery on there, it would really help alot of people. Some say all you need to do for recovery is walk, I don't believe that at all, I think physical therapy makes a world of difference. Keep up the good work, I'm enjoying following this.

Cindi

[Sue R]

Thank you for your kind words, Cindi.

 

There are different ways to treat a problem like this injury, and there are multiple ways to do rehab/therapy, I am sure. What matters is what you and your dog can do, will do, and get done, with good results.

 

I've wondered for years why some toenails on one foot will have more to trim than other nails on that foot, and have found it fascinating to notice how Celt's pads are a reflection of what he is doing with his leg. The wear on his pads has continued to become more and more even between the two hind feet, and I'll get a good photo in a day or two to show that. The feet were too dirty this evening to get a photo that shows that.

 

I do belong to Orthodogs although I have never posted a message or question there. I have appreciated reading messages that I found relevant to our situation. I was very surprised to recently see one topic in which many people extolled the virtue of cold laser, but yet another topic in which everyone who replied seemed to dismiss physical therapy as not needed. I do see people mention doing ROM and getting information from other websites to do their own rehab, but I feel that working with Shari is much more beneficial than trying to read about exercises, doing them, and evaluating his progress myself. She is a trained professional and can see and evaluate things that I am not experienced with, plus she has equipment (like the cold laser and treadmill) that I don't have.

 

I guess I've never considered posting about this topic on Orthodogs, and don't think I would. I have mentioned it on FB for anyone I know who might be interested. Thanks for your comments!

 

Meanwhile, having had a lack of success at doing the cross-legged exercise here at home (Shari made it look so easy, and I got a good photo to be my guide for how it should look), I've gone and substituted an extra trip up and down the stairs for it (usually three times a day, when I do two trips after his walks) and gone back to ten reps of the three-legged dog. We'll see if Shari can teach me how to manage to do this one on my own tomorrow at our appointment.

[ness_bc]

I have appreciated reading this. Some people aren't so fortunate to have access to brilliant rehab specialists so have to make do with what they can find online by way of information. I am on Orthodogs as well. My young BC had surgery for a luxating patella which has somehow turned into a saga and a half.

 

She is now 14 weeks post-op and still having 3 legged episodes on occasion. Not great. Her specialist wants to give things another month to see if the situation improves. She still has slight muscle wastage in her LH (surgery side)compared with her RH. She had her first swim in the dog pool yesterday so am adding that to her program a couple of times a week to see if that helps things.