Charlie's Story - Getting Back on your Feet with Physiotherapy

Although acute spinal injuries in dogs and cats are extremely serious, many can be effectively diagnosed and treated. Charlie is just one dog who has suffered, and recovered from, one of these conditions. Charlie’s story goes to show that with quick intervention there is a good chance of a full recovery. The accompanying image shows Charlie's vertebral disc compression demonstrated on CT.

View video of Charlie on dry land and in the hydrotherapy treadmill.

Until recently 'Charlie' was a happy healthy Beagle living in suburban Melbourne with his two parents. Although Charlie was becoming elderly at the age of 13, he was still active and had no major conditions.

In early May 2006 all this changed suddenly, when Charlie presented to his regular veterinarian with acute onset hindlimb paralysis. Due to his severe symptoms, he was quickly referred to the Southern Animal Referral Centre for specialist assessment. At this point Charlie had lost all ability to ambulate or even support himself using his back legs.

To complicate matters, Charlie's owners were overseas. In light of this a phone consultation was arranged and Charlie was soon admitted to the Centre for an emergency CT scan.

Charlie's scan was quickly organised and was completed very soon after admission with the actual scan taking less than 60 seconds after Charlie was anaesthetised and taken to the scanning area. The scan showed intervertebral disc disease, where two of his intervertebral discs (the discs form cushions between the vertebrae) had become displaced. The disc material was pressing on the spinal cord, causing the clinical signs of pain in the affected region, as well as hindlimb paralysis. This type of disc protrusion does not typically respond well to medical management and, after consultation with Charlie's owners, a decompressive surgery, known as a hemilaminectomy, was performed. A hemilaminectomy involves surgical exploration of the spinal canal and removal of the disc material. This is challenging without advanced imaging diagnostics, as the surgeon may not know exactly where the damaged disc material lies. Indeed, there may be more than one site with damaged disc material. Reducing the 'guess work' in this situation leads to quicker surgeries and the opportunity for far better outcomes for patients. The recent availability of dedicated companion animal CT and MRI in Melbourne has greatly increased the ability for accurate diagnosis of these conditions.

After the surgery, Charlie's neurological function gradually improved, but his injury meant that he would need significant rehabilitation if he was to make a full and timely recovery. He continued to have deep pain sensation in his hind limbs and early post-operative physiotherapy played a major role in his recovery.

Physiotherapy commenced the day after surgery to facilitate the healing process and prevent secondary complications of immobility. Soft tissue massage was utilised for sensory stimulation to the hind limbs as well as increasing circulation to the muscles. Joint range of motion and frequent position changes were also encouraged as Charlie was unable to do this for himself. During his rest times Charlie was placed on a specialised cushioned bed designed for use with immobile patients.

Charlie's rehabilitation swiftly progressed from passive exercises to active use of his limbs. In this capacity, the underwater treadmill was invaluable to Charlie's recovery and is one of the major physiotherapeutic tools used in a large range of cases.

On land he was unable to move his hind limbs although could stand with support. Charlie's first attempt in the underwater treadmill revealed that he was able to initiate movement of his right hind limb as the water supported his body weight. Through daily treatment in the underwater treadmill and facilitation of hind limb movement by the physiotherapist, Charlie slowly began to improve and strengthen his hind limbs. On discharge from the centre Charlie was able to ambulate weakly with support. By this time Charlie's owners had returned to the country and attended a physiotherapy appointment to be shown an individualised home exercise program for Charlie's continued rehabilitation. Charlie has attended twice weekly for hydrotherapy in the underwater treadmill and has had a further physiotherapy review to best tailor his exercises and progress his recovery.

At eight weeks after surgery Charlie remains a little unsteady. At present, however, his owners' biggest concern now is trying to keep up with him so he doesn't get into too much mischief!

The CT and specialist surgery services at the Southern Animal Referral Centre are available 24 hours a day, 7 days a week for emergencies. Physiotherapy and underwater treadmill is available Monday through Thursday of every week and is provided by Animal Physiotherapy Consultants. APC consult from their other major centre in Doveton, where underwater treadmill facilities are also available.

If you have any questions about advanced imaging for spinal diagnostics, specialist surgery or physiotherapy and rehabilitation, please do not hesitate to call the Centre on (03) 9532 5261.

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