International Association of Animal Therapists
Case Study

16/10/2019

Avi - Sudden onset hind limb collapse

Avi and his owner Lesley had been out walking when Avi suffered sudden hind limb collapse, he was rushed to the nearest vet who then referred him immediately to the Royal Dick in Edinburgh where he was admitted.

 Avi had suffered pelvic limb paraparesis due to suspected fibrocartilagenous embolism ( FCE) or acute non-compressive nucleus pulposus extrusion ( ANNPE) - these conditions are almost identical. He was in no pain and he was allowed to return home within days. His treatment was to be done via physiotherapy to improve his voluntary movement ( particularly left hind) and assist in preventing any further muscle loss. His veterinary surgeon hoped that Avi would return to walking independently with minimal neurological deficits.

 I met Avi and Lesley for the first time on 12/9/19 - Avi had no bowel or bladder control, he was unable to stand, pelvic limbs were dragging with the left hind being considerably worse than the right he was unable to lift his tail. He was eating and drinking well and bright in himself, bicep femoris, glutes and TFL showing minor atrophy. I massaged Avi, PROM exercises and treated him with Photizo to boost healing. I left the Photizo with Lesley with instructions to use it 3-4 times a day from the base of his neck to the tip of his tail and PROM exercises.

Avi and Lesley had some problems to deal with - Avi weighs 14 stone, and there are several stairs from the house to get Avi to street/garden level and he was carried down during this time.

On my second visit a week later Avi had improved considerably but had lost weight - he had regained control of his bowel and bladder and was standing with assistance for short periods He was walking - his left hind was dragging and he tired very quickly. I treated Avi with massage and PROM exercises, encouraged him to stand on 2 deflated balance discs to aid proprioception and left Lesley some strengthening exercises. Sit to stand was used - both difficult and tiring for Avi, each time his hind limbs were placed incorrectly they were corrected. Lifting his right hind limb and holding it he was able to weight bear on the left for 3 seconds only.

Lesley is fortunate to live on a hill - she was walking him uphill slowly on flat even ground, correcting the limb when necessary and going a little further each day. She then progressed to walking him on a variety of terrain for short periods

My third visit - Avi had regained some weight , movement was improved but still toe scuffing and knuckling over on the left hind limb. Avi was treated once again and a variety of exercises left for Lesley to aid strength and mobility. These included sit to stand, slow walking to work muscles harder and maintain balance, continuing with uphill and downhill walks, stationary standing side to side head movements putting weight on to both right then both left limbs.

My fourth visit - Avi was negotiating obstacles around the house with no issues, managing stairs with close supervision, stand to sit was square, tail carriage was higher, holding up his right hind he managed to balance for over 10 seconds on his left. He was massaged, PROM and additional exercises . He was due to go back to the Royal Dick within the week.

Royal Dick visit: They were delighted with Avi and how much progress he had made in regaining not only movement but strength and mobility, they didn’t need to see him again and Lesley was to keep continuing with the rehab plan.

Avi was a joy to treat, a lovely character and Lesley was an absolute stalwart and worked incredibly hard to get him mobile again.

Case study conducted by IAAT Member Jill Gunn (member number 1658)

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