Kiah's PT appoinment

[kiahpyr]

I finally got Kiah into seeing a physical therapist. She was nice did measurements and watched her walk. Kiah has muscle atrophy in her right leg due to the tplo surgery she had back in March. There's also pain in her left knee. Kiah's over compensating on her front wrist due to the excesses weight being put on the front legs. That was all good to know.

Here's the part that made me shake my head. First she pushed science diet j/d saying that the supplements in it is better than any supplement I can give my dog. I said I wasn't feeding my dog that stuff, so she pushes liquid fish oil. Kiah would need 10 pumps twice a day. I declined that also. I was under the impression from my vet who referred me that the PT would show me exercises I could do at home, so I didn't have to take Kiah back. That was so wrong. The PT wants me to get the pain under control for two weeks then start the physical therapy. If I go back I have to spend more money for her to teach me stuff.

She suggested pain meds, laser therapy, stem cell injections, adequen injections, or acell vet. I'm going to research to see what is most effective that won't break the bank. Laser therapy wasn't too bad. I wonder if it works.

[Itsapyr]

April I think Cortney gives adequen injections to Jack and not sure if Deanne does to Kodiak or not. I know Jack also walks on a treadmill.

[Baroooo]

Laser treatments can do wonderful things - as can adequan, fish oil, NSAID's and stem cell treatments. No-one here is going to be able to tell you which will work and which won't without knowing the exact problems - which joints if any have developed arthritis, is there cartilage damage anywhere, ligament or tendon strains - (and perhaps a medical degree! -lol). That said, when she is pain free, you can stengthen the atrophied muscles through PT, but how to get her pain free is the question. Hydro-treadmills, swimming, and regular treadmills can all work really well to rebuild atrophied muscles. Cavaletti and hill work can also be great (free) tools once the dog is comfortable enough to do them.

I totally understand not wanting to spend a boatload of money, but sadly PT isn't done overnight. Even when you're seeing a PT once a week for laser or ???, there will be exercises and stretches for you to do at home between sessions. In order for a therapist to be most effective, however, they need to see the dog as it progresses through its treatments - whatever they may be. What works for one dog, won't always work for another. Is the therapist also a vet? Several of the options she suggested cannot be done by layperson.

What worked best for me was finding a team that worked together to get my animal back on track again. An orthopedic surgeon who had a working relationship with a vet who was also a PT, and who had additional PT's working for her. It was expensive. I had to drive over an hour one way, to get to the weekly PT appointments. I had to ice the dog on the way home, and blew all my disposable income that year. I wouldn't wish it on anyone. Now, I have an incredibly close relationship with that dog that I know I wouldn't have if we hadn't gone through so much together.

I'm saddened you have to go through all of this. It won't be fixed overnight, so try to look at the long term results. Explain to the PT your concerns about expense and time. They may be able to help you with solutions. Like Cortney, I give my own adequan injections. I actually buy the equine version - exact same chemical, strength, etc., just different packaging. I was doing the injections for about $25each vs. $100+ at a vet's office.

There are enough of us on the board that have been through similar experiences, so keep us up to date on Kiah's progress and we may be able to offer new ideas/easier ways to do things.

Heal fast Kiah - we're pulling for you.

[kiahpyr]

The main issue is muscle atrophy in the right leg along with inflammation in both knees. I haven't been giving her fish oil because she's a pain to give pills too. A couple of people on the orthodogs group suggest grizzly salmon oil which is liquid. I'm going to order some of that and hope Kiah likes it.

I did tell her money was a concern. Dh got told that he'll be laid off of his job. That's why I took Kiah in now while we had the money. I guess overall I'm upset with my vet for giving me wrong info. He told me the PT would give me stuff to do at home with Kiah at that appointment and I wouldn't have to keep going back. I understand she needs help and I would do anything for my animals. This just happened at the wrong time. So if there's anything I can do at home that would be great. I feel the PT person won't help me unless I do exactly what she says. I already turned her down on the food and supplements and she wasn't happy about it.

Here's the run down of the treatments estimates
Vet-Stem $2500
ACell Vet $710
Adeqan Injections for 13 months $837 (1st 8 are done intravenously in 1 month period $415) The rest of the months are given at home by me. It looks like I get 10 injections for $140.45.
Laser Treatments 6 sessions in 2 weeks $204 then she'll assess Kiah's response and determine continued frequency of LASER therapy

I do get a free 30 minutes session on stretching exercises.

This is her recommendation...
After two weeks of additional pain management alone, I recommend starting Kiah in the underwater treadmill 2-3 times a week. The buoyancy of the water relieves pressure on the joints thus minimizing pain during walking but the resistance of the water allows for active muscle strengthening. Underwater treadmill costs $50.00 for an individual session, $270.00 for 6 sessions, or $510.00 for 12 sessions.

After two weeks of underwater treadmill therapy, I recommend scheduling a 45-minute appointment for instruction in therapeutic exercises that can be performed with Kiah on a daily basis. This session costs $60.00 and would be repeated every 4 weeks to adjust and increase difficulty of exercises.

ETA: Has anyone heard of Vaxamine K9 or Flexile Rx? What about Traumeel & Zeel?

[Baroooo]

Wow! I can't believe she jumped right to stem cell treatments. That's usually reserved for cases of severe arthritis, degeneration or defect in a joint. What a shame the PT's not really willing to work with you. My husband's company got bought out last year, so I know the panic of suddenly "no job". This economy isn't helping anyone.

Find a large kiddy pool. You can fake hydro-treadmill sessions in a kiddy pool if it's large enough in diameter that the dog isn't constantly on a tight turn and you can get the water deep enough . The water should be over the dog's knees/hocks - just about to the armpits for limb strengthening without an exagerated gait. If it's too shallow they walk like Hackney horses and end up putting more stress on wrists and knees. Too deep and they float away. Of course, you'll have to leash walk around the outside of the pool every step she takes, or climb in and stay in the middle pivoting as she walks. If you use a round pool, be sure to switch directions every couple of laps so she doesn't get one sided.

What does the PT intend on lasering? The knee inflammation? Do you know anyone with a laser who would lend it to you? It sounds extreme, but I know dog show folks with lasers, and lots of horse people have lasers they use at the barn. Would the PT be willing to show you her regime, and then have you continue it on your own?

Any friends with swimming pools they'd allow Kiah to use? Swimming is also a really great, no impact strengthener. It must be done in a careful controlled manner, and for most dogs, a life vest allows them to slow down and swim more steadily. They are able to use their legs more evenly and worry less about bouyancy and keeping their heads above water. Start with less than you think. It's a workout using unfamiliar muscles for the dog.

If there's heat in the knees, would icing help? I love the cold wrap bandages sold for horses. You could possibly use something like that after she has her workouts to help keep the inflammation down in her knees. Make it a snuggle session for 15 minutes - special mom/Kiah time.
I don't doubt you'd do anything for your girl. Hope at least one of these ideas works.

[kiahpyr]

The PT would laser both knees. I don't know of anyone with a laser or a pool. We do have a 10X30 soft sided pool. It would be deep enough just not sure it's wide enough in diameter.

If I do the fish oil I wouldn't do adequan, right?

[Baroooo]

Fish oil and adequan aren't the same. If the fish oil helps, you can skip the adequan. If it doesn't seem to do enough, try the adequan too. If you don't see an improvement after the first month or so of adequan (the heavy loading doses), I wouldn't feel obligated to continue the maintenance doses. When it works, it's amazing. When it doesn't help, there's no change at all, and it's a drain on the wallet for nothing.

The pool sounds perfect. Do laps up and down. Start with no more than 10 minutes and gradually work your way up to 30 minutes. Slowly at first and then with more vigor as strength improves. No jogging - keep it to a flat footed, even, four beat walk.

[kiahpyr]

I forgot to mention the pool is round. It's this one.

[sam.i.am]

We tried Vaxamine short-term and it did not seem to offer enough pain relief, but my girl was in a lot of pain that maybe had more to do with a tumor on her spine (that we did not find until later) than her arthritis. I have heard good things about Vaxamine from others on Orthodogs and K9Arthritis yahoo groups.

I am using Zeel as a supplemental pain reliever for Oliver and I think it has helped him (although not today, but today has been a horrible day for him). But, it has been good for him in the past month or two.

My old acupuncturist used Traumeel and had good results with that, too.

For fish oil, read the amount of DHA (compared to the EPA) as that is the EFA that is most related to inflammation, which would help with pain. I've been supplementing extra DHA and was having good results.

Also bromelain is proven effective for pain as is turmeric.
Good luck with Kiah. I hope you find a combination that helps her.