October 2017

Pet of the Month: 
Barney Hughes 9 Year Old Neutered Male Collie Cross

Barney has only been attending the Smart Clinic for treatment since the beginning of September of this year, but has already made so much progress since his initial presentation.

He was referred to the Smart Clinic after he presented at his first line Vets with tetraparesis of acute onset at the end of August 2017. Barney’s owners had found him at home unable to get up from his bed. He was fully responsive and tried to move, but could not stand without support. No traumatic incident had been observed and Barney had been out for his usual walk earlier that day. A neurological cause was suspected and so Barney was referred for an MRI. The MRI showed a cervical intramedullary lesion at the level of C6/C7 consistent with a high velocity/low volume disc extrusion. Conservative management and physiotherapy was initiated alongside appropriate pain management. At the time of his discharge from the hospital, Barney was still tetraparetic and unable to stand without support, but had retained urinary and faecal continence. Barney is an anxious dog, and can be difficult to handle, which made home management more difficult.

At his first appointment at Smart, Barney managed to sit up into a sternal position with both his front legs correctly placed. He also managed to turn his head to the left, but could not support himself to turn his head to the right. We tried Barney with a rear end harness to support him into a standing position, which worked well as he was not able to weight bear on either the right fore or right hindlimb. Barney’s physical examination had to be fairly hands-off due to his previous negative associations with being handled (defensive aggression), but there were numerous areas of muscular tension (particularly in the right fore) as well as numerous muscle groups that had signs of atrophy (particularly in the hindlimbs).

We started Barney’s rehabilitation programme aiming to restore neuromuscular function on Barney’s right side. As home management was proving difficult due to Barney’s size, weight, behavioural history and owner limitations, we recommended seeing Barney as an inpatient for the day, several times a week. To support the work we were doing at the clinic we also advised his owner how to carry out careful physical manipulation of Barney’s limbs to stimulate proprioceptive awareness of his distal limbs and mobilise his joints. We also introduced exercises such as baited stretches in sternal recumbency to encourage Barney to initiate voluntary movements of his body, improve his flexibility and eye/head/body coordination.

Barney has been attending the clinic three times a week since his initial consultation, where we have been focusing on encouraging normal movement patterns in all four limbs as well as performing intensive stretching of all the right forelimb musculature, to minimise any risk of flexor tendon contracture (as use of his distal forelimb in particular was minimal).

We started assisted gait training on the treadmill following Barney’s initial appointment and at this point Barney managed to initiate a coordinated gait pattern with his left fore/left hind leg but only cautiously initiated stepping with the right fore and was unable to place his paw. He required manual assistance with the placement of his right back paw.

Now during treadmill work Barney is more consistently placing his right hind limb and also shows improved placement and positioning of his right fore. He still requires proprioceptive support during treadmill sessions but is able to initiate a normal walking pattern, with encouragement to place his right fore consistently.

He has responded really well to heat packing and soft tissue work, aimed at ongoing areas of muscular tension, and has become more relaxed during these sessions so that palpation and massage has been much better tolerated.

We have been continuing to manage his pain score and behavioural issues, and Barney has recently become much happier during his stays at the clinic, displaying far less signs of anxiousness/aggression than at the start of treatment. He now bounds through the door with a very enthusiastically waggy tail!

There is still some work to do to achieve adequate mobility in Barney’s right fore, as this has been the worst affected leg throughout treatment, but we are really pleased with how much Barney has progressed in a relatively short space of time, considering the nature of his injury and the fact that he could not walk when we first met him.

He is continuing to come and stay with us as a day patient but is now generally much happier with this set up and hopefully now enjoys seeing us as much as we enjoy seeing him. We are hopeful that it won’t be long until Barney is back standing strong on all four legs! Well done Barney!