SPECIES: Dog
BREED: Mongrel
GENDER: Male
AGE: 2 years
NAME: Jarot
Clinical case
Sudden onset of paraparesis, the forelimbs are hypertonic and placed into an extended position under the abdomen.
X-ray examination
absence of evident alterations in the spine, left sacroiliac ligament detachment (suspected nerve injury)
Clinical examination
- Inability to assume and maintain her stance
- Severe ambulatory paraparesis with dragging of the hind limbs if supported by the forelimbs
- Severe muscle hypotrophy of the thigh and rump muscles
- Bilaterally absent hind limbs proprioceptive positioning
- Hind limb flexor reflex absent bilaterally, weak L1-L5 panniculus reflex, absence of response and sensitivity at L6-Cd level, Hind limb sensitivity absent bilaterally, Anal reflex absent (open anus)
- No tail movements, no sensitivity on tail tip pressure
- Bladder and bowel incontinence
TCVM (Traditional Chinese Veterinary Medicine) clinical exam
- Vigilant sensory state, animal is responsive, fearful, reacts easily, difficult to examine (uncooperative), barks at a distance (constitution: metal)
- State of the Shen: good
- Ear: warm
- Tongue: Moist pink/red
- Pulse: slow-strong (weaker on the left)
- Distal end of hind limbs: warm
- Distal extremity of forelimbs: warm
- Body temperature on palpation: hot
- Drinks frequently and voraciously as if thirsty
TCVM diagnosis
Qi/blood stasis with local Qi deficiency of the sacral-caudal nerve
Treatment
- Resolve Qi/blood stasis to return to proper Qi/blood flow, reduce pain and resolve paresis/paralysis
- Tone up the local Qi
- Promote peripheral nerve repair
Therapeutic protocol
- Laser puncture at points BL23, BL39, LIV3, Liu-Feng
- Treatment of point GV-1: the animal appears more relaxed and cooperative
- Treatment frequency: 2x/week for 2 weeks then 1x/week for 6 times finally 1x/2 weeks for 3 times
- Duration of treatments: 4 months (total 13 sessions)
7th therapy:
- able to maintain its stance
- not yet able to take a few steps
10th therapy:
- able to take its first standing steps
- knuckling and tendency to walk on the knees persists
- initial wagging with inability to completely lift the tail
- control of urination
11th therapy:
- spontaneous walking with all four limbs alternating the tendency to walk with flexed hind limbs with the ability to support weight with correctly positioned feet
- normal and spontaneous urination with good control of the sphincters
- wagging with inability to completely lift the tail
- control of urination
13th therapy:
- Able to assume its stance spontaneously and to walk and run slowly with all four limbs
- ataxia persists
- hind limbs maintained tonic during gait
- active wagging movement of the tail
- improved muscle tone
- able to go up and down the stairs and on and off the sofa
By Dr Wita Wahyu Widyayandani, Semer Vet Clinic – Bali, Indonesia