Case 11: Fibro-cartilagenous embolism
publication date: Aug 7, 2008
Bertie, Labrador, Male (neutered), 01/01/99.
Clammer Hill Road, Grayswood, Surrey.
Known Conditions:
29/04/06: Seen by emergency vet, ;
Acute onset paralysis both hind limbs after jumping for ball whilst on walk.
Right hind = some conscious movement, and deep pain sensation.
Left Hind = extensor muscle rigidity, permanent tensing of muscles, no pain sensation. Given high dose steroid and hospitalised.
30/04/06: Left hind = No proprioception, increased/ rigid muscle tone, +ve withdraw reflex, and deep pain sensation.
Right hind = less affected, able to weight bear, with assistance. Cage confine and high dose steroids.
02/05/06: Transferred to TPC, transported by KB to Noel Fitzpatrick Referrals for Spinal injury investigation, orthopaedic, or neurological.
G.A. Myelography performed, revealed FIBRO-CARTILAGENOUS EMBOLISM , t11/t12 vertebral region. No surgery, cage restrict and physiotherapy.
03/05/06: KB collected and transferred back to TPC for hospitalisation and physio as instructed by Gerry O'Roidern Neurology specialist. (onto R/D diet as overweight and now hugely reduced exercise)).
04/05/06: Already approx 30% weight bearing/ proprioception on right hind.
Massage physio carried out 4 times daily along with swaying, bunny hopping atc to encourage use of legs.
05/05/06: Appears better still, much brighter in himself, less depressed, lots of cuddles!
06/05/06: Transprted to Noel Fitzpatricks by KB for lesson in physio and use of Magnopulse treatment. Start Magnopulse 4 x daily for 10 minutes along with physio and assisted walking.
07/05/06: 4 x Magnopulse treatments and physio, massaging etc.
(Magnopuse is the use of electrically stimulated magnets that assist in blood circulation, and lymph drainage, therefore reduces swelling in deep tissues.)
08/05/06: Weight bearing today ++++ on right hind, although left not much improvement, using sock on left foot as drags when walks.
09/05/06: 4 x Magnopulse treatments and physio, big improvement in Bertie's attitude, more co-operative, and seems to enjoy.
10/05/06: 4 x magnopulse and physio.
11/05/06: 4 x magnopulse and physio.
12/05/06: 4 x mangopulse and physio, steady improvement, left leg still very rigid, and if tries to walk too fast, or cock leg to urinate, Bertie tends to wobble and fall over. But he appears confident, and now difficult to keep calm in garden!
13/05/06: 4 x magnopulse and physio.
14/05/06: 4 x magnopulse and physio.
15/05/06: 4 x magnopulse and physio.
16/05/06: 4 x magnopulse and physio, KB transported to Noel Fitzpatrick Referrals for check-up, Gerry very pleased with Bertie's progression and improvement. Advise try go get into Greyfriars 23/06/06 or some swim sessions.
17/05/06 - 31/05/06: hospitalised at TPC, with 4 daily session of magnopulse and physio, (forced and relaxed) along with assisted walking.
31/05/06: Home to owner, advise regarding diet, walking, only 10 minutes lead exercise 3 x daily, and cage confine when go out to prevent any problems arising when not able to supervise. Also avoid Bertie playing with his brother Henry unless several people around to help!
| DATE |
SESSION
NUMBER |
SPEED
(k/h) |
DURATION
(MINUTES) |
NOTES |
| 07/06/06 |
1 |
3.4 |
5 |
Check up, doing well, still ataxic when gets excited, or tries to go too fast, also muscles have wasted quite badly, especially the left hind as still tends to be held quite straight, start treadmill to do controlled muscle build up |
| 09/06/06 |
2 |
3.4 |
5 |
Left leg still very tense, but good proprioception. |
| 12/06/06 |
3 |
3.6
3.4 |
5
2 |
|
| 14/06/06 |
4 |
3.6 |
8 |
| 19/06/06 |
5 |
3.6 |
8 |
| 21/06/06 |
6 |
3.6 |
10 |
| 23/06/06 |
7 |
3.6 |
10 |
| 26/06/06 |
8 |
3.6 |
10 |
Still tendency to scuff left. |
| 28/06/06 |
9 |
3.6 |
10 |
|
| 30/06/06 |
10 |
3.6 |
10 |
| 05/07/06 |
11 |
3.6 |
10 |
Scuffing left ++ |
| 07/07/06 |
12 |
3.6 |
10 |
|
| 10/07/06 |
13 |
3.6 |
10 |
Doing well. |
| 12/07/06 |
14 |
3.6 |
10 |
|
| 14/07/06 |
15 |
3.6
4.0
3.6 |
2
3
2 |
| 17/07/06 |
16 |
3.6
4.0
3.6 |
2
3
2 |
| 21/07/06 |
17 |
3.6
4.0
3.6 |
2
3
2 |
| 25/07/06 |
18 |
3.6
4.0
3.6 |
2
3
2 |
Doing well. |
| 27/07/06 |
19 |
3.6
4.0
3.6 |
2
3
2 |
|
| 31/07/06 |
20 |
3.6
4.0
3.6 |
2
3
2 |
| 04/08/06 |
21 |
3.6
4.0
3.6 |
2
3
2 |
| 08/08/06 |
22 |
3.6
4.0
3.6 |
2
3
2 |
| 11/08/06 |
23 |
3.6
4.0
3.6 |
2
3
2 |
| 14/08/06 |
24 |
3.6
4.0
3.6
4.0
3.6 |
2
4
2
4
1 |
Doing very well. |
| 17/08/06 |
25 |
3.6 |
10 |
Ran off 15/8, then taken for long walk yesterday, ataxia ++++ today. |
| 21/08/06 |
26 |
3.6
4.0
3.6 |
2
3
2 |
|
| 30/08/06 |
27 |
3.6
4.2
3.6 |
2.5
2.5
5 (First incline ramp) |
Advise try go get into Greyfriars 23/06/06 or some swim sessions. |
Very good overall recovery, occasional scuffing of left hind, and ataxic only if over-excited, or given too much exercise the previous day.
Re-examine 7 days to make sure holding muscle.
11/10/06; Unfortunately, Bertie has spent the last 4 weeks in kennels whilst his owner had a knee replacement, and has suffered quite severely as a result, with muscle wastage in his hind limbs, and he has become very ataxic again.
Right hind = medial rotation of foot with very exaggerated pace.
Left hind = held away from body, very stiff movement.
| DATE |
SESSION
NUMBER |
SPEED
(k/h) |
DURATION
(MINUTES) |
NOTES |
| 11/10/06 |
28 |
2.8 |
7.5 |
Sudden stop.
Stiffening of right hind and ataxia +++ |
| 13/10/06 |
29 |
2.8
3.0
3.2
3.0 |
3
2
4
3 |
Very unsteady on left hind, with exaggerated pace. |
| 16/10/06 |
30 |
2.8
3.0
3.2
3.0 |
3
3
3
3 |
Slightly ataxic, right hind worse than usual, tendency to lean right when standing.17/10/06; Try on Vivitonin 100 mg twice daily to improve blood profusion to tissues. |
| 18/10/06 |
31 |
2.8
3.0
3.2 |
3
3
4 |
|
| 20/10/06 |
32 |
3.0
3.2
3.4
3.6
3.2 |
2
3
3
2
2 |
Amazing, different dog , full of life & wanted to do more! |
| 23/10/06 |
33 |
3.2
3.4
3.6
3.8
3.2 |
4
4
3
1
2 |
Full of energy! Advise try go get into Greyfriars 23/06/06 or some swim sessions. |
| 25/10/06 |
34 |
3.2
3.4
3.6
3.4 |
4
3
4
2 |
Full of beans! Many people are commenting on how lively he now is! Walking straighter already, & not leaning so much & both legs moving better. |
| 30/10/06 |
35 |
3.2
3.4
3.6
3.4 |
2
4
4
2 |
|
| 02/11/06 |
36 |
3.2
3.4
3.6
3.4 |
2
4
6
3 (incline)
|
| 06/11/06 |
37 |
3.2
3.4
3.6
3.4 |
3 (incline)
4 (incline)
4 (incline)
3 (incline) |
| 13/11/06 |
38 |
3.2
3.4
3.6
3.4 |
2
4
5
2 |
Bertie appears a bit ataxic today, been taken out for 1 hour long walks last 2 days! |
| 20/11/06 |
39 |
3.2
3.4
3.6
3.4 |
2 (incline)
4 (incline)
5 (incline)
2 (incline) |
|
| 27/11/06 |
40 |
3.2
3.4
3.6
3.4 |
2 (incline)
4 (incline)
5 (incline)
2 (incline) |
| 11/12/06 |
41 |
3.2
3.4
3.6
3.4 |
2 (incline)
4 (incline)
5 (incline)
2 (incline) |
| 18/12/06 |
42 |
3.2
3.4
3.6
3.4 |
2 (incline)
4 (incline)
5 (incline)
2 (incline) |
Doing so well, returned to same/better level than before, advise continue vivitonin and cosequin, and reassess in new year, warned owner that an hour long walk does not equate to a treadmill session as it is not under controlled conditions and could cause further damage! Advised 30 minutes lead exercise twice daily. |
04/01/07; Re-examine, doing very well, having 20-30 minutes lead exercise twice daily, and not being allowed to chase balls/his brother etc!
