Winston Smith

Pets Age: 
10 year old
Pet Type: 
Male, German Shepherd
Problem: 
Fibrocartilaginous Embolism

Winston is a 10 year old Male White German Shepherd Dog. He started to have mobility problems earlier this year in the form of bilateral hip and stifle osteoarthritis. In mid-August he became acutely paraplegic. After 24 hours a degree of left hind function had recovered but he continued to be monoplegic in the right hind. Poor core stability and his concurrent degenerative joint disease lead to inability to recruit his hind limbs into a functional gait pattern.  His owner had invested in a hind limb cart and had started to take him out in this. The problem with this measure was that this exacerbated his forelimb dependent gait pattern.

He presented to the Smart Clinic two weeks after his episode of paraplegia. No diagnostics had taken place at this time. On neurological assessment, proprioceptive placement testing, the withdrawal reflex, the patella reflex and conscious pain perception were normal in the left hind. Left hind extensor thrust was present. On palpation of the right hind the musculature was flaccid and proprioceptive placement testing was negative. The patella and withdrawal reflexes were present but sluggish. Conscious pain perception of the right hind distal limb was present.

Although there was a very likely diagnosis was a fibrocartilaginous embolism or type III disc extrusion, it was felt that it would be prudent to have Winston evaluated by a specialist neurologist. He was seen and following examination, this working diagnosis was agreed upon. Seeing as he was making daily improvements by this stage, the need to use Magnetic Resonance Imaging was not felt to be pressing.

Rehabilitation therapy at the Smart Clinic was commenced in early September. Initially our main focus was on alleviation of secondary muscle spasm (in his back and as he progressed in his right adductors) and in recreating functional neuromotor pathways and improving proprioception. As well as working in the aquatic treadmill with assistance twice weekly he received electro-acupuncture. His physiotherapy homework regime included encouraging him to stand correctly with support, hind limb balance cushion work and sensory stimulation. After a week of treatment he was able to walk independently for short distances for 20-30 seconds.

As he progressed we were able to increase the challenge to his core function. After six weeks his exercise tolerance had increased dramatically and he showed an ability to walk for up to 15 minutes. The main finding was that the amplitude of right hind protraction was poor and that he had a tendency to scuff the nails on the right hind. As he continues to progress this has become less dramatic. He has built considerable muscle mass and tone in both hind limbs. Withdrawal and patella reflexes are normal in the right hind. Proprioceptive placement testing in the right hind is present but slightly delayed. He has been on Cimalgex non-steroidal throughout and on attempted withdrawal hind limb stiffness has been exacerbated.

Over two months, Winston has progressed from paraplegic and facing a future in a hind limb cart to independently mobile. His cheeky personality has come back into view with his mobility. He visits the Smart Clinic on a fortnightly basis currently.