Case Studies

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Session 1

Name, species, age, weight:

Vogue, Labrador Retriever, 7 years old, 34kg.

Veterinary diagnosis/interpretation of the animal’s problem:

No Veterinary diagnosis has been made. I observed tension in the thoracolumbar region T11-L2 of the spine, lumbar sacral region discomfort (most likely hip dysplasia/ arthritis), left-hand biceps femoris and semitendinosus slight pain response.

Treatments, Veterinary medicines, supplements and complementary therapies:

• Phenobarbital for epilepsy (last episode Jan 2023)
• Regular 2km walk on weekdays and 5-10km walk/run/hike on Saturdays
• 1 x per week swim
• Montego Karoo large breed food
• No supplements.

Master problem list:

• Thoracolumbar region T11-L2 of the spine
• Lumbar sacral region
• LH biceps femoris and semitendinosus.

Subjective:

Slightly nervous and unsure, she relaxed after effleurage and skin rolling. Only allowed left side to be worked on (15 minutes), kept wanting to get up when attempting massage to right side.

Objective:

Left hind biceps femoris and semitendinosus tension and sensitivity greatly reduced after first massage.

Indicate lumbar discomfort- did not allow to be worked on.

Indicate thoracic spine discomfort.

Assessment:

Biceps femoris and semitendinosus went from hard and tense to a more malleable and softer feel.

No work done to lumbar region.

Thoracic spine region of the longissimus, no texture change felt but the dog’s behaviour relaxed, she no longer indicated discomfort at the end.

Plan:

The dog benefited from the manual therapy in three quarters of the observed problem areas.

Focus on observed painful areas.

Suggest swimming, especially for lumbar discomfort.

Will be performing one massage session per week on Sundays as this is her rest day.

Suggest x-ray at the vet to determine the deeper cause for thoracic and lumbar discomfort.

Session 2

Subjective:

Owner said happier to walk further during Saturday hike.

Slightly unsure, she relaxed during effleurage and displayed slight nervous behaviour (licking and sitting up). Allowed both left and right side to be worked on (right side 12 minutes, left side 10 minutes). Sat up during the session a few times but lay back down.

Objective:

Left hind biceps femoris and semitendinosus tension was still present and required massage, sensitivity greatly reduced compared to first massage and release occurred sooner.

Lumbar discomfort- allowed pressure to sacrum for 2 min + 2 min did not enjoy targeted fingertip massage, did however enjoy vibration in the area.

Thoracic spine discomfort still present, enjoyed light petrisage but showed discomfort when more pressure was applied.

Assessment:

Biceps femoris and semitendinosus went from hard and tense to a more malleable and softer feel sooner than in first session.

Lumbar region showed less discomfort and allowed more work to be done.

Thoracic spine region of the longissimus, no texture change felt but the dog’s behaviour relaxed with light pressure. As the muscle was worked she preferred the massage to move to a medium pressure but wanted to move away with firmer pressure.

Plan:

The dog showed improvement from the manual therapy in all observed problem areas ranging from slight to major improvement.

Continue to focus on observed painful areas once per week.

Suggest heat application to lumbar region.

Utilize acupressure points in the next session.

Session 3

Subjective:

Owner applied daily heat for 5 minutes to lumber region, said she enjoys scratches to the area more now. Stands up easier.

Lay directly on blanket set out for her for the massages. Indicated excitement with tail wag and alert face with relaxed eyes. Settled quickly once I began slow breathing and asking for permission to proceed with the session.  Allowed 15 minute massage to each side.

Objective:

Moving more confidently when playing with the ball.

Standing for longer, not always wanting to sit.

Left hind biceps femoris and semitendinosus tension and sensitivity greatly reduced, very minimal to discomfort during massage.

Performed acupressure to bowling ball points (GB29, GB30 & BL54) and lumbar discomfort reduced a considerable amount, allowed petrisage in the area after acupressure.

Thoracic spine discomfort still present but 60% less discomfort compared to Session 1. Response was extremely positive to acupressure point BL23, she was leaning into my fingers.

Assessment:

Biceps femoris and semitendinosus no longer hard and tense, slight stiffness in the muscles in the beginning but relaxes quickly to a more malleable and softer feel.

Allows work to be done to Lumbar region only after acupressure is applied to bowling ball points.

Thoracic spine region of the Longissimus responding positively but slower than other regions. Shows less pain but still sits up to move away.

Plan:

The dog is benefitting greatly with manual therapy and will continue with 1 x per week sessions.

She is walking further and needing to sit a lot less.

Happier to be touched in lumbar region.

Apply heat to thoracic region at home.

Has begun swimming.

Discussion

Vogue is able to walk further, is in less daily discomfort and a happier and more confident dog overall since beginning regular massage sessions.

Owner feedback:

“When we go out on a Saturday, she jumps more easily into the car and is making us walk further on our daily walks. At home she spends less time sitting and is more active around the house. She loves to be rubbed on her bum so much that she is coming to us and asking for it.”

I personally would like for Vogue to so see the vet and get an X-ray of her spine so that we can have a better understanding of why she feels discomfort and I can adjust my techniques accordingly.

I’ve learnt that if one technique does not work or the dog does not allow the technique to be performed, that there are many other techniques to try that the dog will allow, for example petrisage to the lumbar region was not allowed but acupressure was happily accepted. Vogue enjoys music and the time taken to connect before the session and I will be implementing these tools with future dogs.

Overall, I have learnt that one requires time, patience, consistency and full awareness of animal’s behavioural signals for the dog to receive the most benefit and pleasure out of the manual therapy session.

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George, a five year old blind Schnauzer, presented with chronic RHL lameness and was diagnosed with IVDD (lumbosacral). Physical rehabilitation, acupuncture and laser therapy were performed weekly together with a daily home exercise program, that was performed vigilantly by his owners. George presented with challenges being completely blind, which limited the ability to perform some rehabilitation exercises and progression of the rehab program at times. The combination of regular treatments, monitoring and persistence and dedication of his owner, enabled George to improve, build up his core strength, muscles and use of his RHL.

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At five months of age Riley presented with progressive hindlimb weakness and a swaying gait. She was referred to one of the largest specialist veterinary practices in Johannesburg. Riley was Ortolani positive on both hips but not painful. The specialist surgeon asked for an MRI scan which revealed spinal compression from T2 to T8. On 5^th July 2021 Riley underwent left sided hemilaminectomy T2 – T8 extending to dorsal laminectomy T2/T3/T4. Following the surgery, she retained deep pain perception but was non-ambulatory. Her physiotherapy began immediately post-op.

The referral centre has an in-house veterinary physiotherapist who applied ice twice a day in the initial phases. Therapeutic laser and TENS (transcutaneous nerve stimulation) were performed twice daily. Comfortable that Riley’s pain was being managed, therapeutic exercises started a few days after the surgery. These included assisted standing with activation of the abdominal musculature. As she responded, standing bicycles, weight shifting, and rhythmic stabilisation were added. The right hind limb showed some degree of extensor rigidity while the left was flaccid. Passive range of motion helped to overcome the rigidity and allow other exercises. Riley tired very quickly.

After two weeks of intensive therapy Riley was allowed outside in a support sling. When outside the therapist assisted with support, walking and hind limb paw placement. Her family visited twice a week as they did not reside close to the facility. Riley really responded so well to these visits and tried even harder in her sessions that followed the family interactions. By the end of July (3 weeks) Riley was able to push herself up into a standing position and hold this for 3 seconds. Underwater treadmill sessions, with gait training, started soon after this.

One month after the surgery Riley was discharged. Physical rehabilitation sessions continued, and Riley’s family were given home exercises. One of these exercises was to place Riley over a peanut and rock her backwards and forwards. Riley was able to sit properly at this point. Assisted sit to stands were added. She made great progress once she was sent home. The power of love can never be underestimated!

Riley continued to progress until November 2021 where she seemed to have a dip in physical ability. At this point she was still being carried up and down the stairs and helped a great deal at home. It was suspected that the hips may be playing a role as Riley was growing and moving more. The program was adjusted to a twice weekly. The sessions alternated between hydrotherapy and land-based exercises. Riley was still dragging her hind paws. Booties were supplied. Despite her physical shortcomings she was determined to move and very active.

The time spent walking in the underwater treadmill gradually increased. Riley walked inclines and declines and at different water levels depending on her ability and capacity on the day. Riley was constantly challenged with therapeutic exercises. Increasing the difficulty of the exercises enhanced the outcome. She progressed form weight shifting on a solid elevated surface, to an inflatable disc. Riley was walked over foam mattresses, up and down ramps, over cavaletti rails and around obstacles. Many of these exercises were also performed at home.

Riley’s rehabilitation continued until September 2022 – a journey of 15 months. Her recovery was possible because of good surgical interventions, appropriate in hospital care, intervention by trained physical rehabilitation practitioners and a dedicated family. Riley is mobile, pain-free, and happy.

To watch a video of Riley’s amazing rehabilitation progress please click HERE.