Friday, July 30, 2010

Our regimen

I realized that it might be helpful for some of you out there (if you are out there) to know our PT regimen for Otis. You might want to start it immediately after your puppy gets clearance, regardless of whether you take him/her to PT him/herself. But this is just what we do, so don't ever do anything you think might hurt your puppy...when it doubt, ask your vet if this is okay.

1. Massage: We give each hip a daily massage. Starting with long strokes down each back/hip/leg. Then strong circular motions. Then we do the "deep" massage. Each hamstring and quadriceps gets a deep kneading motion (like if you put the muscle between the forefinger and thumb and gently squeeze the tension out). Get to know your dog's muscles--know his hip (which is in the middle of the side, not on the backbone), know his quad/thigh, his hamstring, his calf muscle and his achilles. Know his knee from his ankle, etc. It'll help you to diagnose issues.

2. Stretches: We gently manipulate each affected joint. When his knee was tight, we would force him to extend his knee. For his hips, we support his knee (NEVER put pressure on the joint itself!!) and push on his thigh, backwards (like if he had his leg extended out behind him). He hates it and fights us, but we stay firm and reward him greatly. He gets very agitated with the stretching, but it's super important. If he doesn't get back his range of motion, he won't be able to jump up on the couch or into the car, or go up/down the steps normally. He needs to be able to extend his back legs at 165 degrees each. Or so we're told.

3. Exercises, Easy: Sit/stand. He sits and then stands. Voila. Pretty simple, but works those back thighs. Just like if you or I were doing squats.

4. Exercises, Easy: Walk in circles/figure 8s. When he goes on his daily 5-15 minute walks, we walk him in circles (counter and clockwise) or in figure 8s. The inside leg's muscles work harder that way.

5. Exercises, Easy: Balancing. I support him under his belly and lift each back leg. He is supposed to get 7-10 seconds on each leg. Right now he has 7 on the right and 2 on the left.

6. Exercises, Harder: Walking backwards. I mean, it might be easy for some, but Otis hates walking backwards. We're supposed to be walking him backwards up hills.

7. Exercises, Harder: Obstacle course. Put pvc pipes on aluminum cans to raise them up a little bit, about 2 feet apart. He walks over one pipe, then another, etc. This helps him to pick up the back legs. Eventually you raise up the pipes, narrow the pipes, etc. Haven't tried this yet. :-)

8. Exercises, Harder: Water walk. The physical therapist uses a water treadmill, but we can't afford that. :-) So we take him to the lake. Walk him through the surf up to his shoulders back and forth. Let him swim a little in between. The resistance is good for his muscles but easy on the joints.

There ya go. :-)

Update from the physical therapist.

On Monday we returned to the physical therapist's office and heard good news. Aside from the fact that we all got stuck in the elevator...yikes...the pt thought Otis was doing well.

She thought he was walking better and his weight was distributed more evenly. On a normal dog, about 60% of the weight is borne by the front legs and 40% in the back. Otis, last time, was about 80% front and 20% back. She feels he's about 75/25 now. Which is an improvement. His left hamstring is no longer too tight for his knee to straighten and he has gained 15 degrees of movement in the hip. He's also gained 1/2 inch of muscle on the middle of that thigh and 1/4 of muscle further up the thigh. Apparently our exercises, massages and stretching are making a difference.

But the bad news? The right side shows no improvement. But seeing that our hard work is paying off just motivates you to keep going. So we're gonna focus in on that right side, keep up the exercises and medication and hope for the best when we go back next month.

Again--I can't stress enough the importance of physical therapy. Do it! Even if it means your puppy has to chill next to the hot tub instead of running around in the yard...it's only for a couple of months. With what we've already been through, what's a couple more months??

:-)

Sunday, July 11, 2010

Update

So it's been 10 days--how's he doing? Well, better and not better, I suppose. :-)

His range of motion seems to be getting better--he is tolerating the stretches much longer, which is good. His left side is getting stronger too, as he can balance for a while on it! The right side, not so much, unless it's directly underneath him. We do a lot of the "sit" then "stand" exercise. And we also try to make him walk backwards quite a bit. I think he's starting to improve. But I'm also an eternal extreme optimist, so take that with a grain of salt!!

The only problem we've had? He's developed some diarrhea. Bleck. For the first time since he was a three-month old puppy, he had an accident on the floor. Well, multiple accidents. Poor guy. He's rounded the corner, now, but that was tough on his body. And because he wasn't eating, we couldn't medicate him yesterday either. That means he had a tummyache and sore legs. Yesterday was a bad day.

But this morning is a new day, and we're off. He's eating better (still exhausted from yesterday's trials), and we'll be back to our regimin in full force. We go back to the physical therapist in 2 weeks and his 11 month "birthday" is on Wednesday. Can't believe my baby is getting so old. :-)

Thursday, July 1, 2010

Small setback.

So Otis has had a small setback.

He's been acting a bit crazy lately--laying down, not wanting to walk. And sometimes he favors his back legs and shuffles along after a long day. So I took him in to the vet on Monday. She was concerned that his back end looked too thin--she noticed some muscle atrophy. At the same time, she wanted to rule out the Lyme disease reoccurring, so she took more blood. Today we saw the Physical Therapist to see what else could be the matter and how to fix it.

We went in and told her what a normal day in Otis's life looks like. Three walks, a lot of playtime, some swimming, etc. She told us we're doing way too much with him. Did measurements on his thighs and on his hip range of motion. He's supposed to have 160 degrees in both hips; he has 120 in the left and 130 on the right. He also has tight hamstrings and atrophied quadriceps. Poor boy! We've been unwittingly hampering his recovery by pushing him so hard. :-( Bad mommy and daddy.

Apparently he wants to play and do stuff with us so he's been shifting his weight to his front end, making those muscles extremely strong--but keeping his back end weak.

The remedy? Back on pain meds (she says he's in a bit of pain when exercising) and rest. He can do two 5-10 minute slow walks a day, massages, damp heat treatments and stretching. Next week we start daily exercises like balancing, walking in figure eights, walking slowly in knee-high water and walking a small obstacle course. It could take 3 months to get his thighs back to a normal size and he may never get back full range of motion after surgery, but we are to follow this procedure for at least 3 weeks. Then we will go back and see if we've made progress and then we can go from there.

Live and learn, I guess. Note to all: take physical therapy seriously. We should have started this 6 weeks ago. After you've paid so much for surgery, it's difficult to justify really expensive physical therapy, especially when your puppy seems to be so much better and even normal in many ways. But fractures take 6-8 weeks to heal, and then it could be 2-3 months until the muscles and ligaments get back to normal--especially since he was probably favoring those same muscles even before surgery.

Sigh. At least we know now. And maybe we'll save someone out there the guilt? :-)