Some case studies assessed and treated by Julia:

Casper, the Golden Retriever, was 18 months old when he was referred by the veterinary surgeon regarding a 12 month history of left front limb lameness.

The injury occurred at 6 months of age (when a large adult dog bowled him over in play) and he was severely lame from that date. He had extensive veterinary diagnostic procedures (6 months prior to the physiotherapy referral) and medication but the lameness/limping still persisted at walk pace.

Diagnosis / Clinical impression:

Tendonitis of the left long head of biceps. Inflammation of the left rotator cuff insertion. Prolonged postural gait adaptation due to shoulder impingement.

Physiotherapy treatment included:

Manual therapy techniques that included specifically graded mobilisations and soft tissue manipulation. Electro therapy included ultrasound and laser therapy techniques. Re-education of gait. Postural strengthening techniques.

Outcome:

Excellent, full recovery.

Owner's comments:

The owners were delighted about the successful result. Prior to the physiotherapy referral, they said they had felt like "giving up" as the lameness had persisted for so long (and in such a young dog). They have now said that they would strongly recommend physiotherapy.

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Sandy, the Golden Cocker Spaniel, was 8 years old when his hind limbs suddenly lost all power and he collapsed. Sandy was also unresponsive to sensation / reflex testing and was immediately referred to a specialist orthopaedic veterinary surgeon. The surgeon performed a T.13/L.1 laminectomy operation.

Post-operatively, Sandy was still paraplegic (no hind limb power), faecally and urinary (bowel and bladder) incontinent, (though there had been a slight regain of deep pain sensation). The prognosis was guarded.

Physiotherapy treatment included:

Neurological physiotherapy rehabilitation techniques that included management goals to:

• normalise postural tone
• recruit and facilitate sensory activity through normal movement patterns
• stimulate proprioception (sensory related responses) at joint level
• encourage standing to improve circulation and respiratory function
• improve bowel and regulatory functions
• improve kidney and bladder function
• help maintain bone integrity

Manual therapy included mobilisation techniques and neuro-muscular stimulation therapy.

Once the spine was stabilised, hydrotherapy was introduced in conjunction with the physiotherapy.

Outcome:

Graded functional recovery over the weeks and months.

Owner's comments:

The owners feel that Sandy has made a 95% recovery and are thrilled with his progress. He is walking and exercising well - up to 2 miles, twice daily.

They feel that he would not have made it through without the team input.

This is an example of a complicated neurological problem that responded very well to the team working closely together.

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