Page 10 - Clinical Connections - Summer 2024
P. 10
RVC RESEARCH STUDY VETERINARY SERVICES RVC.AC.UK
Neurology
THE THERAPEUTIC JOURNEY OF A DOG
CALLED WORM
Holly Smith, Head Neurology and Rehabilitation RVN and owner of Worm
orm, a five-year-old miniature and pain scores carried out to ensure he was slides on a textured surface or wobble
dachshund, came to RVC Small comfortable. He regained the movement cushion. Worm was a good boy for his
W Animal Referrals last August in his back legs the same evening as his physiotherapy and enjoyed the attention!
following an acute onset of back pain and surgery and was able to wag his tail! Worm In hydrotherapy he used the underwater
difficulty walking. recovered well postoperatively. treadmill to improve his walking. This helps
At that point Worm was bright, alert and with strengthening, by walking against the
responsive. Physical examination was resistance of the water. With someone in the
within normal limits. However neurological treadmill every session, they could also help
examination revealed mild ambulatory make sure he was placing his feet properly,
paraparesis, proprioceptive ataxia in the practising and improving proprioception.
pelvic limbs and thoracolumbar kyphosis. This was not Worm鈥檚 favourite thing to do
Postural reactions were reduced in both and some bribery with treats was needed!
pelvic limbs. Spinal reflexes were intact in all Worm has made a full recovery from
four limbs. The thoracic limbs were normal. his intervertebral disc extrusion and
Cranial nerves assessment was normal. hemilaminectomy surgery. This doesn鈥檛
However, spinal hyperaesthesia was MRI image showing a normal disk (above) mean it might not happen again and
and disk extrustion (below)
detected on palpation of the thoracolumbar therefore he is kept a close eye on and isn鈥檛
region. These findings are consistent with a allowed to climb stairs or jump. There are a
T3-L3 myelopathy. lot more ramps in his house now!
Given the mild nature of the clinical signs,
conservative treatment was elected in the
first instance. Worm was started on medical
treatment for pain and a period of strict cage
rest, which meant he was confined to his
crate and only taken to the garden on a lead.
After a period of four to six weeks, Worm
was comfortable, and his neurological Worm had to have strict cage rest again
examination was normal. At that point he for at least four weeks after his surgery. It
could gradually increase his exercise and was important that he didn鈥檛 try to run, jump
stop his medication. Worm had recovered up or climb stairs, which could cause him
well from this episode of back pain and pain and possible deterioration. He was
myelopathy. back to going to the garden on a lead for a
A few weeks later it was noticed that Worm change of scene and the toilet, three to four
was 鈥渨obbly鈥� on his pelvic limbs again, times a day for five to ten minutes only.
seemed uncomfortable and not himself.
Physio, hydro and K-laser treatment
Admission as an inpatient During his recovery Worm had laser,
Worm returned to the RVC in October, physiotherapy and hydrotherapy. The
when he was assessed by the Neurology exercises improve strength and balance
and Neurosurgery Service again. He while maintaining a positive muscle Worm on the underwater treadmill (above)
and wearing their 'doggles' (below)
was paraplegic, with intact nociception memory, so the body doesn鈥檛 remember
(paralysed back legs, could still feel them). abnormal as normal, instead of returning to
He was an inpatient for four days. normal function.
MRI of the thoracolumbar spine Laser was used on his back to help the
identified an intervertebral disc extrusion wound heal and give extra pain relief. These
at T12-T13 intervertebral disc space, are short sessions and comfortable for him.
which was pressing on the spinal cord. A He had to wear 鈥渄oggle鈥� eye protection
hemilaminectomy was performed. during the sessions.
Pain was managed pre and Physiotherapy exercises include
postoperatively with opioids (methadone), massage, passive range of motion on
along with a non-steroidal anti-inflammatory his back legs. We then incorporated
drug and a nerve pain medication. active/assisted exercises, which involved
Initially Worm鈥檚 bladder was checked supported standing, rhythmic stabilisation
regularly to see if he could urinate by himself, (wobbling) on a wobble cushion and foot For small animal referrals, please call:
01707 666399
Email:
qmhreception@rvc.ac.uk
10 Summer 2024
