Case Studies

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George is a five-year-old miniature Dachshund. He initially presented as he had a non-resolving skin condition - he was biting his back legs and needed to have a cone on his head at all times. He was on antibiotics, steroids, cortisone creams and still could not be trusted to have his cone removed or he would chew his back legs until he had open wounds. 

His owner, a human doctor, noted that the skin lesions on both his back legs were over where she expected his sciatic nerve to run and so wanted a second opinion and to have George assessed for pain. 

On initial examination George had a mildly hunched spine and had wounds over his lateral fifth digits on toes and also over his lateral hamstring muscles where the main sciatic nerve runs. He was also very painful when touched near his wounds. On a biomechanical examination George had spinal restrictions in his upper lumbar and wasting of his spinal and gluteal muscles. He was also very tight in his gluteal and hamstring muscles which was causing nerve entrapment and pain. We updated George's diagnosis from a skin condition to a spinal, musculoskeletal and nerve pain condition. 

George was treated with acupuncture, osteopathic techniques, myofascial release techniques, laser, PEA and Chinese herbs. Given the very tight muscles creating the nerve entrapment his owner was given a massage prescription. George responded favourably to the massage, and it became a daily routine - much loved by George. George only needed the cone when unsupervised after the first visit, and it was removed completely following the second visit. On the subsequent visits his muscles and fascia felt much more relaxed, and we were able to progressively add additional massage techniques and locations to George's massage prescription. 

George is now completely pain free, lesion free and off all pain supplements. I see George intermittently for a biomechanical review and acupuncture to maintain his spine. His owner now does all his maintenance with keeping his legs comfortable with daily massage.

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Jelly Bean, a German Shepherd Dog, was adopted byBrad when she was six months of age. She had severe hip dysplasia, and he was told to expect shorter than average life with lots of medication required. She went along reasonably well for the first few years, Brad noted she had a few quirks, such as moaning a lot when she slept, but thought that was just her unique way. At around five years of age Brad noticed she was becoming grumpy and aggressive, he took her to a behaviourist who suggested she be checked out by a therapist. The therapist revealed Jelly Bean was in severe pain and recommended acupuncture, hydrotherapy and home exercises be commenced immediately. Results were rapid, and, when Jelly Bean started to sleep quietly, Brad realised just how much pain she had been in previously. Jelly Bean’s therapy continued and she went from strength to strength - she lost weight, her medications were reduced and she started running around happily again. She started to slow down at around ten years of age, but lived very comfortably for a couple more years; much longer than expected. Brad commented that the difference the pain management therapy made to her life and theirs was immeasurable. 

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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.