Baloo Williams

Pets Age: 
6 year old
Pet Type: 
Boxer x Staffie

Doing well despite the fear’

Baloo first attended the SMART Clinic in September 2014, presenting with left hind lameness. Examination and radiography under general anaesthesia at his first line vets resulted in diagnosis of left cruciate disease. He had ruptured his right cruciate ligament in 2011 and surgical repair with meniscal debridement had taken place. Recovery following surgery had been eventful with extremely high pain scores in the fortnight following surgery. As a dog who experiences a high level of fear in unfamiliar situations, the fear associated with recovery may have contributed to his pain perception at the time. Being fear aggressive, he does not tolerate veterinary interventions or examination well and this was amplified following the initial surgery. His owner was keen to avoid further surgery at all costs due to the traumatic experience that the initial surgery on the right had developed into.

He had originally displayed a moderate left hind lameness with insidious onset. However this had developed acutely into a severe non-weight bearing lameness in the days leading up to radiography.  When first seen at the SMART Clinic he had been rested and had received oral meloxicam daily for two weeks. There had been a marked improvement to his gait pattern. The main findings on gait evaluation were that he was offloading the left hind in stand. He showed a 4-5/10 left hind lameness characterised by lack of extension of the stifle in the cranial phase of the stride and reduced duration of the stance phase. The right hind also showed a 1-2/10 lameness characterised by abduction of the limb. He showed a cranial bias to his gait pattern and a compensatory thoracic swing to the right. His tail also showed exaggerated lateral movement to the right in a compensatory fashion.

The fact that physical examination has not been possible has been one of the main challenges in this case. With familiarity and a lot of chicken and fish hand fed through his muzzle, our vets and nurses have been able to enter his personal space and stroke his neck and back but he is extremely defensive about any movement towards his hind end. At the beginning of treatment he was rather kyphotic through his thoracolumbar spine, suggestive of compensatory high tone in his epaxial musculature. Although his overall muscle definition is significant, taking his breeding into consideration, there was obvious visual atrophy of the left hind.

He started to attend the clinic 1-2 times per week. As described above, we had no option but to take the ‘hands-off’ approach. Much of his rehabilitation work involved walking on the aquatic treadmill and designing homework exercises that could be carried out at home. His pyramid toy has been particularly useful in this case.

There was a momentary ‘blip’ in progress in November but he has rallied from this well.

He had to change his non-steroidal from Meloxicam to Firocoxib due to gastrointestinal irritation. In December he started to become intolerant to this and his owner took him off all medication and supplements. This settled his digestive tract but this necessary but abrupt change caused an increase in left hind stiffness, seen mainly after rest. He has also started on MSM supplement and this has coincided with further improvement.

We started treatment nearly five months ago. He is no longer lame on the left hind.  The quality of his movement, including his core function and neuromotor control of his stifle flexors and extensors, has improved. This has enhanced his biomechanical efficiency, taking the load off his epaxial muscles so that he no longer shows a kyphotic thoracolumbar outline. Muscle mass and definition of the left hind has improved dramatically and has provided the muscular ‘shock-absorption’ for the left stifle that he requires. His proprioceptive awareness of this limb has also improved. All of these changes will reduce the severity of future wear and tear on both stifles. He is bright and playful at home and has started doing some interval jogging with his owner in preparation for running off-lead, circumstances allowing. This just goes to show that although it is not ideal to treat patients ‘from a distance’, sometimes it is our only option and with patience and an open mind this can be very effective.