Thursday, 21 September 2017

Subluxation of the canine hip - meet Ronnie


Ronnie is a 2 and a half year old Golden Doodle – Golden Retriever / Poodle cross. He is a big boy with stunning eyes. 

Some months ago he started to display issues with his mobility. He lives in a house where there are quite a few steps to climb to get indoors. He started to look painfully at these steps up to their house. His Mum said it was like an old man who was reluctant to try them. He also became stiff and hyperextended his back end. His gait was definitely way off balance. This was not due to overwalking as, when his exercise regime was severely cut down, he still displayed these issues 

His local vet could not determine what was going on with him and referred him to a specialist vets. They took CT scans of his elbows and X-rays of his hips. The good news was his elbows were fine but his left hip showed mild subluxation. His right hip was also fine. 

When a joint completely dislocates or separates between the joint and the bone, this is commonly described as luxation. This is often what happens in dysplasia. But when the joint is only partially separated, this is referred to as subluxation although it can be equally painful. The signs for both are similar with limping, lameness, pain, licking or change of mood although subluxation can come on quite quickly as it is typically due to a recent trauma. 

There are a number of ways to treat this, depending on the severity, including surgery. In Ronnie’s case, his was mild and the surgeon recommended that he started with physical therapy. This included massage, exercise and hydrotherapy. If this did not resolve the issue, then surgical interventions might be necessary. He was given some medication although the Gabapentin he was given, did not agree with him. He is now just on NSAIDs 

He has already started hydrotherapy and I was asked to fill in the multi-modal therapy of physical therapy and exercise. Although he is a large boy, he is very soft with a stubborn and a “I-don’t-think-you-should-be-touching-there” glare given when he is not happy. 

He was perfectly fine with 30 minutes work on his right hand side but was not happy with his left – the side of the issue. In fact, he walked out into the garden, under the tree. I sat with him chatting away and eventually he let me rest my hand on his hip. Luckily, we found his Go-To muscles were his left shoulder and his hip. Any amount of massage there sent him straight to sleep. Alternating between the lovely muscle and the iffy muscle seemed to work. He gave up trying to out stare me and rested under the tree. 

 His Mum is now armed with homework and exercises plus a quick warm-up and cool-down routine as Ronnie struggled more after exercise. Hopefully the physical therapy, exercise and hydrotherapy should start him on his road to recovery and may prevent any surgical interventions. 


Saturday, 16 September 2017

Benefit of having your own Personal Massage Therapist

“Hi I’m JC. I’m a little bit of a canine athlete, competing in shows most weekends during the season. I have the edge on my competition though. I have my own Personal Massage Therapist called Dr Les. 


My Personal Massage Therapist came to see me just over a year ago when I started to fail at a couple of events during a show. My Mum was told about Dr Les who came along to see if he could help. I’m not always the best of friends with everyone who comes into my house. When Dr Les walked in holding what looked like a big fluffy red bed I thought “Hmmm…why has Mum let him into my bedroom?” so I walked around eying him up and sniffing him out. He smelt OK so I decided to plonk myself in his lap to keep him company. He then spoke to me and asked if he could touch me. Well….Ok…..I guess so. Wow…..was I happy I agreed to that. He did something to me which released a lot of heat from my skin. It felt great. I just had to lay down on the bed to get more of that. 

He said that I was rather tight in my thigh muscles. I don’t know what that meant but he made a big difference. I decided I’d had enough after 40 minutes and walked away. But he didn’t leave, he was chatting to my Mum. So I went back…for more. And more. It was really lovely. 

I didn’t see him again until the same happened. I just couldn’t do the sit properly. It hurt a bit. I had to remain standing. I know that was not what my Mum wanted but I just couldn’t get there in time. She wasn’t angry though. In fact she must still be pleased with me because, guess what,…Dr Les came back. I wasn’t going to be all standoffish this time. I bowled him over with my excitement. I felt he needed extra kisses and cuddles as he must have missed me after this time. As soon as he put that red bed down I threw myself on it and looked at him longingly. He said something about ‘flirting’…it must have worked as he started his magic again. 

He taught my Mum something called The Locomotion which she has to do before I compete. It’s great fun. She now does that every time I get out of the car and I feel all warmed up. None of the other Mums do The Locomotion to their dogs. They must feel really stiff and cold before they compete whereas I’m all warm and suppley. 

We’re reaching the end of the event season and, as you can see, I’ve won quite a few prizes. Not bad for a 10 year old girl eh? My Personal Massage Therapist has just been again and said I feel pretty good, in between me giving him kisses, licking his beard and doing that flirting thing. 

And my Mum has been doing her homework. I showed him how well by doing the stretching exercises he put me through. They make me stretch my back, which feels nice, and I get a treat while doing it. I call that a Win Win. 

I have two brothers. They don’t have a personal massage therapist. I guess that makes me special. I’m not going to tell all my mates at shows about Dr Les as he’s mine” 

Editors note : If you would like your dog to have a personal massage therapist like JC, just get in touch 

Monday, 11 September 2017

Benefits of physical therapy – and some obscure ones

There are dozens of established benefits from massage and physical therapy. There are the physical and mechanical benefits such as : 

  • Rehabilitation 
  • Prevention 
  • For exercise and sport 
  • To manage pain 
  • Stimulation of the healing process 
  • Increase blood, lymph and nutrient flow 
  • Increase joint movement 
  • To improve muscle tone and strength 

Then there are the psychological benefits including : 

  • Relaxation 
  • Bonding 
  • Reducing anxiety, stress and other emotional issues 

And then added benefits such as : 

  • Give the owner peace of mind 
  • Education 
  • Beacuse it feels nice

Every now and again I get the odd one to add to my list. For example, I was once referred a dog who really struggled to poo. When she came to see me, she hadn't been for a couple of days. Would massage help? Dunno, but stand clear and let's try. For the next few days I received multiple texts from the owner detailing quantity and quality of that dog's movements. It worked. There's a new benefit then...helps to poo. 

And yesterday I added a new benefit. Lovely anxious Whippet Sonny has been suffering from neck issues for some weeks now causing yelps and general depression. He came to see me last month and has now visited a chiropractor who put his pelvis back in alignment while making tweaks to his neck. Yesterday's massage was much easier with Sonny adopting his usual "I'll just lie here Dr Les" pose. 

When I got home I received a message and photo from his Mum saying "First cuddle we've been allowed to have in longer than I can remember! Very rare, he must be feeling better. Thanks again". So there we have it....massage benefit number 7654321 : Increases and Restores Cuddling Ability. That's going to be one of my favourites. 


Friday, 8 September 2017

Canine Regenerative Therapy : My experience part 2



8 weeks ago, we took our Sarah to Dr Stewart Halperin for Regenerative Medicine Therapy.  At that session she was treated with had Plasma Rich Platelet therapy, Arthramid, steroid injection and lubrication during the surgery.  Medication wise, we added Amantadine to her regime.

I really didn't know what to expect.  Would the effects be instant?  Would we start to see improvement in a few days or weeks or months?  Would it work at all?

She regained her mobility quite quickly but still stumbled on her right hind leg for a while.  When that sorted itself out, she decided to stumble on her left hind leg.  A week after surgery we also added twice weekly hydrotherapy to her physiotherapy routine using the 10 metre pool at the House of Hugo. 

As I walk behind my girl at least 3 times a day, I constantly took videos of her walking which I could refer to for changes.  For five weeks, it seemed that not a lot was happening.  But then she started to walk symmetrically, balanced and with more confidence. And her thigh muscles began to appear.  This was quite evident as she developed alopecia over her operation area - meaning she has two baldy patches over her thighs.   You could see through to the muscles - not good for her but good for me to judge progression.  You can see in the video here, when she stops, she quickly corrects her hind leg placement.  A couple of months ago, a rapid turn like that would have sent her legs flying in different directions resulting in a fall.

Dr Halperin also removed her bad front teeth.  Now that doesn't sound a lot, but she must have been in pain from them.  Removing that discomfort seemed to help with her mobility recovery.  

Yesterday we had our 8 week review back at his Chiswick surgery.  I was looking forward to a fresh pair of eyes assessing the outcome.  Encouragingly, he was pleased at the change.  He agreed with us that a major improvement is how she stands up from a sit with less effort.  He followed us walking down Chiswick High Street while taking a video for his records and agreed with my opinion, which is that she is clearly pushing from her rear legs now rather than pulling with her front.  Meaning she is regaining strength and confidence from her hips and thighs.

He performed a physical examination.  Her wrists no longer crackled when moved, her elbows and shoulders felt more solid and her right hip had considerably more movement.  She still showed some reluctance in her left hip, but hey, any relief to her discomfort of bone rubbing on bone has to be a benefit and a result.

It was decided she did not need a top-up this time.  The plan now is to continue with the medication and physical therapy routine with a review around Christmas time. 

As I said a month ago in my first post about her surgery, "it's just arthritis" doesn't have to mean the end. There are options for relief including physical therapy, hydrotherapy, acupuncture, medication reviews with your Vet, laser therapy, making simple but effective dog friendly changes inside your house (we’ve just added ramps everywhere) plus all the new innovations coming along which can give us dog Dads and Mums, more hope now.
video


Wednesday, 23 August 2017

How young is too young to learn canine massage?

How young is too young to learn canine massage? I’ve never really thought about it until the other day when I had an enquiry from a Mum of a young dog who wanted to come along to one of my workshops. I’ve successfully worked with several dogs under the age of 1 and even had a couple come along to a workshop who were 6 months old. One of those ended up fast asleep in the middle of the room after 45 minutes and only interrupted the class with his snoring, while another was too excited about being in a room with lots of other dogs. 

But there are plenty of human Mum and Baby massage groups and workshops available. In fact, Chris’s new grandson, the gorgeous smiley Caleb, went to such a class to improve his motor co-ordination and general body awareness. So why not Mums and Puppies? 

I felt it best to give the Mum a call and see why she wanted the session and to learn more about her dog. We had a 45 minute chat – very thorough. 

As to The Why, the puppy was her first dog, she had only had cats before. She felt she didn’t really know anything about dogs – how they work, how they bond, how they play and, most importantly, how to look after them physically. 

As to The Who, the puppy was a Labrador. His name was Sherlock. He was black. He was cute. He was 18 weeks old. 

Well…let’s be honest, she had me at puppy. Then at Labrador. Then again at Sherlock. I was putty by that time. 

OK…let’s go for it. We felt that the puppy would struggle sitting still, or laying still, in a class format so Mum decided to bring him here. From Streatham in London. A long way to come. That’s dedication for you and a Mum who really wants to go that extra mile (literally in this case) to help her and her dog. 

 I collected Mum, her Mum and Sherlock at the station rather than making them get a taxi or bus. Well….I wanted to see this smasher first hand. He was sitting very politely by the kerb waiting for his transport. Oh….love at first sight. He even sat in my car happily watching the Brighton traffic go past. I don’t think he was listening to my commentary about the Royal Pavilion or the Pier or Roedean or the Lido….he just was in awe of the world. 

During our trip home, I was asking his Mum more about The Why. It turns out that Sherlock has been rather poorly in his 18 weeks with lots of tummy issues, ear problems and has been on antibiotics more times than not. Mobility wise he is fine but he could do with some Sherlock Down Time to help his insides recover and heal. His Mum said “he always looks sad. I want to be able to help him”. 

That did it for me. This was going to be success if it took all afternoon. 

As it happened, we didn’t need all afternoon. We ran through the massage techniques that could be performed on a puppy which would help keep those growing muscles in top condition and others than could help him relax. We used both Sarah and Sam, the magic demo dogs, to try things out while Sherlock entertained himself chewing the carpet. 

 Then it was his turn. Unexpectedly, Sherlock remained in one place throughout the first run through of the routine. A bit of wriggling but no getting up to see what is over there. Remarkable. 

We then took him in the garden for a wee and a leg stretch before checking out what his Mum had remembered. This was the defining moment of my canine career I reckon. Sherlock, remember EIGHTEEN weeks, just flopped in his Mum’s lap, smiled and fell asleep. Yes, there were tears. I might have joined in. 

Was he happy? You bet he was. Was he relaxed? Well he was snoring like a good ‘un. Was his Mum now his best friend ever? Just look at the pictures. Listen to the accompanying video posts. 

 This worked largely because his Mum wanted it to. So much. She needed to know that she and Sherlock will now be a life team. And I think they will. All it took was 3 massage techniques to change his life and hopefully start him on his road to recovery. His Mum performed those three over and over while he snoozed peacefully grinning with an occasional endearing toe stretch. 

My day with Sherlock is certainly going in my book of Top Ten Canine Massage Moments. 






Thursday, 17 August 2017

Canine Regenerative Medicine : My experience

Our Sarah was diagnosed as having chronic arthritis in her knees and wrists about a year ago with possible onset spondylosis. As such, she has been treated with maintenance Metacam, fortnightly laser therapy and fortnightly hydrotherapy. In addition, she goes to see the wonderful Tim Couzens, Holistic Vet, who makes up a personalised and tailored herbal mixture with a couple of homeopathic tablets. 

By and large, she has been OK. But with the summer, she has been stumbling, particularly on her right rear leg. We thought her knees were sore. 

I’d read about Stem Cell therapy for canine arthritis some time back, along with Platelet Rich Plasma therapy (a great video which explains how that works can be found on YouTube here) and now, more recently, a new medication called Arthramid which has been used in horses for a while but is now being offered to dogs by a few specialist vets. 

At the recent VETFest conference I attended, there was a talk about Stem Cell Therapy and I thought that I’d have a google and see if there is anyone who is offering it. I found Dr Stewart Halperin BVMS MRCVS who has several clinics in the UK, the nearest to us being in Chiswick. I gave him a call and, following a thorough and attentive phone conversation, he agreed to see our Sarah. 

On the day of our appointment we had a consultation which lasted well over an hour going through her entire history – not just the arthritis but also her general health and her liver issues – an integrative approach. He took us through the options he offers, explaining that she may not need the most expensive therapy but may be better benefitted with the PRP or Arthramid or even a combination of several. Of course, there was always the possibility that he could not help and she may need surgery or the treatment he offers may not be suitable for her condition. But all would be revealed with appropriate X-Rays. 

We left her at the clinic, as Dr Halperin aims to perform all procedures on the same day, and found a pleasant spot in Putney by the River and near a cafĂ© to wait. Mr Sam was with us and had a Dad Day although he was clearly concerned about where his sister had gone. 

At 16:30 we made our way back to the vet surgery and waited for Dr Halperin to give us the verdict. The most startling thing, for us, was to see the X-Rays. They clearly showed (even we could read them) that her wrists, elbows and knees were fine. However, her hips were not – they were shocking. Dr Halperin showed us that the head of the right thigh bone, which should have a rounded top to fit neatly in the socket of the hip, was almost flattened due to arthritic wear. He suggested there was also likely a genetic underlying cause too. Her left hip was not good, but not as bad as her right. 

Our Sarah must have been in considerable discomfort over the past few months with bone rubbing on bone. He told us that, even under anaesthetic, they hadn’t been able to extend her rear legs back more than about 30 degrees – it should go at least 180 degrees in a fit dog. It took them several attempts at X-Raying her to get a good scan. 

Incidentally, 5 years ago we had been told that their rear leg extension was restricted by Natalie Lenton of the Canine Massage Therapy Centre, when we attended one of her workshops. She had found this likely genetic issue way before any visible symptoms had been displayed. 

What did he do? Lots. He injected an analgesic into the joint, some lubrication, some Platelet Rich Plasma and finally, Arthramid. Additionally, he took out 4 of her teeth which he noticed were badly damaged and would also be causing her discomfort, maybe even adding to her known liver enzyme issues. 

We were given quite a few medications to keep her comfy during her recovery until the therapy settles down, including Amantadine. A survey by Lascelles et al (2007) showed that Amantadine in a multimodal analgesic regimen can help alleviate osteoarthritis pain in dogs. 

Dr Halperin suggested that taking this drug with the NSAIDs she is already on might be a useful adjunct therapy for managing her arthritis. By the next morning she was already refusing her sling, preferring to walk by herself. Dr Halperin told us to continue with the physiotherapy and massage we give her daily and to concentrate the acupressure we also give her, to areas and meridians that will benefit the hips. We also booked her in for a course of intensive hydrotherapy at the House of Hugo, plus a new diet regime. 

Interestingly he also told us we needed to go out and buy a Bio-Flow collar for her. I was rather surprised that a vet surgeon would recommend this but I guess it all goes with his multi-approach to managing canine arthritis. 

It’s been 6 weeks now. She is not ‘fixed’…she has good days and she has not-so-good days. What she doesn’t seem to have is bad days. She is moving more freely, she gets up from her bed easier, she has a great wiggle in her spine, she lifts her knees higher, she does a h-u-g-e stretch immediately after her acupressure and generally seems more relieved. What we need to concentrate on now is her muscles. She hasn’t been using her thigh muscles in a while. Twice a week hydrotherapy at the House of Hugo is making a lot of difference. Her Auntie Tel, the hydrotherapist, gets her to use those rear legs in their 10 m length pool. Gradually the muscle tone is coming back. 

How long will it last? I don’t know. But if she doesn’t feel that she’s got bone crunching on bone for a few days, weeks or even months, then that will have made it all worthwhile. 

Of course, this is just our own experience. It’s not a cure-all, not every dog will respond in the same way and, for some, this type of therapy may not be suitable. It may be, like our Sarah, that they don’t immediately get back 100% fitness. But I’ll happily settle for any relief from bone on bone crunching. However, if you’ve got a dog who has arthritis and you’re open to try options, check out the StemCell Vet webpage – it’s full of useful resources and explanations of what he does. If you know of anyone who would benefit, please feel free to share this page. 

Hopefully, with all these innovations for veterinary options, we’ll soon not have to accept a diagnosis of “It’s just arthritis”.

Thursday, 3 August 2017

“Unfortunately both Archie and Pearl are now rolling about on the floor in front of us, constantly, trying to get massages!!!“

“Unfortunately both Archie and Pearl are now rolling about on the floor in front of us, constantly, trying to get massages!!! “ 

Ooops. 

Meet Pearl & Archie 

Some years ago, at Bark in the Park, we met the lovely rescue Staffie Pearl. She immediately sat in our laps taking every bit of touch we gave out. This was quite remarkable for a dog who had been a street dog who had both front legs broken at some time. She is now 10 with arthritis of both elbows and a stiff back. Her brother, Archie was also rescued and is now 8 years old. His Mum and Dad say that they are no good at fostering, they tend to end up adopting all their foster dogs. I think that makes them excellent fosterers.

After all that time, I was called to go over and teach them how to perform a massage routine that would be appropriate for their age and mobility. Although Pearl is 10 she tends to have the two speeds of a Staffie, zero and 100. Then after a bout of 100 mph, she struggles to get up. Although Archie had no specific mobility issues, he had a cruciate operation a few years ago. 

I always start my workshops with a “Get-to-know-your-dog” session where the owners learn about Palpation – a vital part of any treatment. You shouldn’t just dive straight in with muscle kneading until you’ve had a feel of what is going under that fur. It turned out that Archie did have an issue even though that was not presenting itself in obvious lameness. Touching his lower back was quite reactive. It is possible he is still carrying some imbalance after recovery from his cruciate operation. 
Pearl also displayed an amount of discomfort in her back and legs which would be expected from her arthritis. 

Pearl’s Mum is not able to work on the floor but can work from her chair. No problem.  Pearl simply jumped onto her lap and massage was done there. 

The session went on well past their normal dinner time. Their Dad looked at the clock and said that they ALWAYS get to the kitchen waiting for food at the same time. That day they were already 20 minutes late and not looking for food at all. Well, they were, in fact, asleep. 

When we wrapped the session up, we told them it was now dinner time, which should have sent them into ecstatic bounciness. Instead they looked up at Dad as though to say “Oh Dad…just feed me here. We’re too comfy after all that massage”. 

Pearl & Archie can now go from 0 to 100 knowing that Mum and dad will be able to help ease them out afterwards. 

Their Dad posted a review later saying “Fantastic and informative visit by Les yesterday. gained so much help and information from him which will benefit our dogs in the future. Why didn't we do this sooner??? Many thanks for all the help and advice.” 

It doesn’t matter if you wait a while, learning how to massage your dog whether they are puppies, middle aged or seniors, will help their quality of life. 

Archie

Pearl

Pearl

Pearl with her Mum

Pearl for the rest of the day