SPECIES: Dog
BREED: poodle
GENDER: M
AGE: 11 years
NAME: Kimbi
Clinical case
The patient, who had undergone castration and lumpectomy a week earlier, returned home with an E-collar. The animal suffered a trauma a week after surgery by crashing into a van. Following the trauma, it showed tremors, reluctance to move, food refusal and pain-based behaviour.
Clinical examination
On neurological examination:
- Mental state: alert and responsive
- Posture: Increased base of support
- Gait: Proprioceptive tetra-ataxia, poor ambulatory tetraparesis.
- Palpation: Pain on cervical paravertebral when applying digital pressure.
Therapy
- Before the neurological evaluation (in hospital): meloxicam, catosal, b-complex, gabapentin, ranitidine, lidocaine-ketamine infusion.
- Post neurological evaluation treatment (in hospital): catosal, b-complex, gabapentin, ranitidine, mannitol, solu-medrone, prednisolone, citicoline, vitamin E.
- Hospital physiotherapy protocol
- Home treatment: B-complex every 24 hours until further indicated, Citicoline 1/2 tablet every 24 hours until further indicated, reduction of prednisone dose.
- Physiotherapy protocol by appointment
Physiotherapy protocol
- MLS® laser therapy: one session every three days
- TENS cervicothoracic and lumbosacral area
- Passive joint mobilisation of the four limbs
- Proprioceptive and weight-balancing exercises with Physio Roll
After hospitalisation, the physiotherapy protocol continues at home and by appointment:
- Physiotherapy at home: hot-cold contrast therapy, passive joint movements (three times a day, minimum 5 movements each time).
- Physiotherapy in the facility: twice a week for three weeks, MLS® laser therapy with M-VET, magnetotherapy, functional bandages, Neuro-proprioceptive taping, therapeutic exercises and electrotherapy, then once a week for a further three weeks, balance exercises, magnetotherapy, MLS® laser therapy with MVET.
Laser therapy physiotherapy protocol
- Area: spine paravertebral muscles and IV spaces
- Scan mode
- Intensity 100%
- Initial frequency 18 Hz increased to 36 Hz in the fourth session.
Magnetotherapy physiotherapy protocol
- Before MRI: cervicothoracic area 33 Hz 60% intensity 20 min
- After MRI: cervicothoracic area 50% 50 Hz 15 min, forelimbs 10 Hz 50% 15 min
- For pain management in the thoracolumbar spine, the parameters 50 Hz 60% intensity 30 min are used
Results
- The patient was able to support its forelimbs during the second physiotherapy session and was able to stand with assistance.
- In the third session it was able to sit upright and in the fourth it took its first steps.
- Neurological follow-up evaluation performed three weeks after the start of therapy: favourable evolution, recovery of reflexes, proprioception, superficial and deep sensitivity. Continue with low-dose prednisone B complex for 3 weeks and citicoline every 48 hours.
- At the eighth session Kimbi began therapeutic coordination and balance exercises.
- Two months after the trauma Kimby shows an improvement in gait with improved autonomy in walking and in performing the main bodily functions.
- Continues with maintenance therapy.
Courtesy of Dr Yatzyry Linares Martínez, Camcor hospital, Mexico City – Mexico