Claire's 3rd Hydrotherapy Session 10-28-11

Videos taken at Claire's third hydrotherapy session at CARE in Santa Monica! Her therapy this time was upped to a total of six minutes. It's always divided into three bursts of activity, with two rest periods in between in which she stays in the water but the treadmill is not running. The last video is of the water draining from the tank after her session, so that we could open the door to get her out.

Claire doesn't particularly like baths, which we do in the kitchen sink, so I was surprised at how quickly she took to the water treadmill! Of course, someone is standing at the head of the tank offering her cookies the entire time, so she has a reason to be distracted from the water. In fact, it's quite funny--rather than keeping a nice even pace on the treadmill, she'll run up to me for a treat, then stop walking while she chews it. The treadmill takes her backwards, away from me, so she then has to run up to me for the next treat!

The hand in these videos is the male tech who runs the tank. He kindly left me free to run the camera, and he was better at teasing her with the food to stretch it out. She's only going to CARE once a week, so her progress with the length that they'll give her has been slow. I'll have to start figuring out how to do hydrotherapy in the tub at home as she has just two CARE visits left.

Claire's New Heating Pad

After Claire's latest setback, due to the cold temperatures that day and just the general change of seasons, a friend told me about a thermo heating pad for cats that is reactive to the pet's weight. I had an aha! moment and filed the idea away. The next day, a generous donor sent Claire a $50 check, so I immediately placed an order.

It arrived this weekend, and both dogs have already discovered it! I ordered only one to see how well it would work, but it's obvious we'll need one for the crate and the bed in the bedroom, in addition to the couch in the living room. Chance found it first and nestled in, but as soon as Claire figured out what it did, she laid claim to it, so Chance will have to get his own.

I've always left blankets out in chilly weather, and the pups dug around in them until they were comfortably nestled in. But now Claire seems not to burrow at all due to her back injury, so this will be an invaluable tool in her recovery.

A Friend at PT

Claire had an admirer this week at physical therapy. The therapists used her as bait to motivate a dog who was learning to use a wheelchair, and she was happy to help!

(attempting nose-to-tail exercises)

(doggy traction)

Claire's 5th Adoption Anniversary

Today is the 5th Anniversary of Claire's Adoption! In honor of the day Chance, Claire, and I tried a photo shoot in our garden. I can't imagine life without our girl!

Our Friend LA Pet Tech

Today we started thrice-weekly visits from our friend Kathleen who runs the business LA Pet Tech. Kathleen has a background as a vet tech, so her dog walking/pet sitting service is ideally situated to specialize in caring for dogs with medical needs. She's coming to our home to assist me in doing Claire's physical therapy.

Claire is so wiggly to begin with, and sensitive in certain areas since becoming hurt. Add to this the fact that I've trained her to a certain routine of tricks. And I never pay her off with treats unless she's still, either sitting or more commonly in a "down" position. So getting her to do certain exercises, especially the standing ones, by myself has proved impossible. I know it's just a matter of patience and approaching the exercises as new training, but it's not been easy and I want Claire to get the benefits of p.t. right away. So I'm resorting to paying for home visits: add that to the list of costs due to IVDD.

Kathleen has a calming presence for both Claire and myself, and I learned a few lessons from her today that will make it easier to do the p.t. on other days when she is not involved. She's just the help I've needed! I'd like to recommend her publicly to anyone in the San Fernando Valley, whether your dog has special needs or just requires love. Contact her via Facebook here.

A Visit to the GrandPAWrents, and Beginning Physical Therapy at Home

(What I usually get when trying to get Claire to "follow the treat" nose to sky, nose to shoulder, or nose to hip! I've trained her too well to lay down and roll over, so I'm finding it impossible to do her standing exercises. Ugh!)

Claire came home from her pt evaluation with physical therapy exercises to do at home. I was glad to be visiting my folks for a week to have an additional hand in the beginning. I'm still having trouble doing the exercises with Claire on my own. We're focusing mostly on stretching her rear legs and shoulders, doing exercises to stretch shoulders, biceps, hamstrings, and iliopsoas muscles, and rotate hips, as well as some traction exercises and neck stretches. The exercises are supposed to be done twice a day and take 30-45 minutes. She has special Zukes peanut butter treats just for pt, so the whole thing becomes quite the event!

I'm making sure she stretches well at least once daily, and taking her to the pt clinic every Tuesday. I'm also augmenting by continuing laser therapy at the local holistic vet every Friday. This will be the routine for the next 3-4 weeks, till the end of September, when Claire will be re-evaluated by the pt clinic's vet for possible adjustments to her therapy regimen.

(Claire showed some tension yawns during our first couple of therapy attempts but is generally pretty relaxed.)

The best part about visiting the grand"PAW"rents? Pictured below. ;o)

(Chance gets snuggles)

Claire's been enjoying more supervised motion per the pt vet's recommendation. She had been on strict crate rest through the end of August. While she's still not cleared for long leashed walks, jumping of any kind, or stairs, she does get to have an "open crate" situation around the house and yard as long as I'm around. When I'm out I'm crating her for her protection.

Claire had her first visit for physical therapy at the pt clinic this last Tuesday, Sept. 6th (the initial visit was an intake evaluation with their vet). They did stretching exercises with her much like those assigned at home, then did acupuncture with electrical stimulation, and a B12 shot into her left rear thigh. The staff there is great with Claire! I tried to address the problems I was having getting her to do therapy with me, but they basically said nothing more than "patience" and "keep trying." I know it's mostly my prior training with her that's making this difficult, so it is going to take time to perfect this routine. I can't wait for the halfway vet evaluation where we can address adding hydrotherapy!

Meanwhile I'm continuing to address correspondence on Claire's behalf and fundraise for her vetting. The Red Barn pet store in Tarzana does not allow collection jars at registers, and it took me about four visits to get to speak to a manager. They offered to help in other ways, so I'll approach them again when I'm ready to do a raffle or auction. I've also been following up on verbal commitments made previously to contribute once donations could be made directly to a vet, as we're now able to do that to the pt clinic. I can't thank Claire's supporters enough for making such great care and treatment possible. I'll be forever indebted to all.

We've started new safer routines in the car, with a wire crate secured tightly by bungee cords. This is now the only way Chance and Claire travel--previously they'd had a bucket seat that elevated them but they weren't as secured into it, so while they didn't distract me or cause accidents, they weren't safe if we were involved in one. The new crate fit only in the back seat, so I'm getting adjusted to being unable to pet them or see them as well but they're doing fine in it. We have a ramp that we'll use to get in and out once Claire is cleared for that type of movement.

Claire's Seven Supplements

I've written before about a few supplements Claire's been on, but the physical therapist has prescribed four more, so I thought I'd recap what she's been on for the last two and a half weeks (and will continue indefiinitely).

When she was initially diagnosed in June, Claire was prescribed Prednisone to reduce inflammation and Tramadol for pain relief by the neurologist, with Gabapentin specifically for nerve pain, if needed. I started that several weeks into the process when I noticed Claire licking her side quite a bit, and refilled it once, so she was on it three-four weeks before I discontinued. The Gabapentin has to be made at a special compounding pharmacy as Claire's weight is so small, so it runs about $40 every two weeks.

The holistic vet put her on Traumeel, a homeopathic anti-inflammatory, and Dismuzyme, which contains enzymes to promote healing. She takes three tablets daily. The Traumeel comes from the vet as it's a concentrate that they mix. The Dismuzyme I found for half the vet price on Amazon.com.


The physical therapist has added Denamarin, which contains Sam-E, a half tablet daily, as well as Super B Complex and Vitamin E. She recommended the Nature Made brand of human-grade supplements because they are somewhat more regulated than other herbs. I added CoQ10 myself as I've heard other IVDD dogs taking it, and the vet said it can't hurt. I bought the Denamarin direct from the vet for the first time but will research to see if there's a better option. The company does have a rebate for a few dollars available here. The other supplements ran me about $80 at Walgreens but I've since found them at Costco as well. The PT vet also suggested we resume the Gabapentin as I mentioned Claire was still doing a fair amount of licking at her side.

So, Claire now starts her day with 1/2 tablet of Denamarin, taken on an empty stomach. I take a shower and give her a few minutes to digest that, then pass by with a Dismuzyme tablet. The Traumeel is also to be given on an empty stomach, so I go brush my hair and teeth, then give her a dropper of that. A few minutes later, I give her 1 ml of Gabapentin liquid. That finishes her morning meds. Sometime in the afternoon she takes another Dismuzyme tablet, and perhaps another dropper of Traumeel. With her meal in the evening, I add another Dismuzyme tablet and 1/2 of a B Complex tablet, which must be crushed or she'll leave it in her bowl. Every other day, I add 1 Vit E gelcap, 1CoQ10 gelcap. She's also getting a tablespoon of canned pumpkin with her dinner to help prevent constipation, and I cover her kibble with water to get some extra liquid into her. Quite the diet! It's really not as bad as it seems when it's written out, but she's getting used to eating something every time I approach her.

If your pet has IVDD, what changes did you make to their diet post-diagnosis? Please leave a comment on the blog.

Claire's CARE Evaluation & Initial Intake Appointment

Claire was all ready for her intake evaluation at CARE, California Animal Rehab, after nearly two solid months of strict crate rest! We saw Dr. Debra Voulgaris on August 25th for the intake, but the rehab appointments will be led by a physical therapist rather than a veterinarian.

(waiting)

The vet met with us in a separate room to get a picture of what's going on, then took us into the main open therapy area to do the physical exam. Claire was a little overwhelmed with all the goings-on, with so many people and other animals around. It made her uncertain with the examination itself, but she still did great.

(measuring the girth of Claire's muscles to see if the sides of her body are even)

(checking range of motion)

(checking Claire's reflexes)

The doc did a full neurological assessment, but as usual Claire was quite stoic, and she only yelped once, though she did pull back a bit when her mid-back was pressed.

Dr. Voulgaris ultimately said that though she doesn't deny that there is or was some level of back injury, the pain Claire presented with on Thursday was more muscular, in the Iliopsoas muscle, which wraps around her leg from the hip, and perhaps sciatic pain. Her shoulders were also quite tight. The yelp came when the vet was examining the Iliopsoas.

(nervous licking)

Dr. Voulgaris formulated a plan for Claire's physical therapy based on once a week visits to CARE, and twice daily homework. The exercises seem quite thorough but not easy to do by myself. I've put them up in a separate post so I can refer to them easily. There will be a halfway check by the vet after four weeks, and an outtake exam at the end of the eight weeks. The total will come to somewhere above $1500. Modalities covered in Claire's on site care plan include laser therapy, acupuncture or acupressure, and physical exercises.

The one exercise that makes me nervous is traction. I've heard all kinds of prohibitions against this for dogs with spinal injuries as it's too easy for them to twist in a wrong direction and end up doing damage. I'll be giving that one some thought before I decide to proceed with it.

I mentioned I was excited to see how they would acclimate Claire to hydrotherapy or the water treadmill since she's not particularly fond of baths even in our tiny kitchen sink. When I checked out, the front desk person said the Dr. wanted to hold off on water therapy until she re-evaluated at the halfway point. I need to drop her an email to find out her reasoning. I was really surprised since she hadn't mentioned that when we were talking together. Hydrotherapy is one of my main reasons for seeking out therapy for Claire, since I don't have that kind of equipment at home. If it's not warranted given her injury, that's one thing, but I can't imagine she wouldn't benefit from it.

She's also added a few supplements to Claire's diet that I'll cover in a separate post, and put Claire back on Gabapentin, a nerve pain killer, since I mentioned she'd been licking her sides quite a bit. We'll be adding these things once at a time so we can see how Claire's reacting.

Recommendations were absolutely no jumping up or down, no walking her, no sudden movements, but more supervised open crate time with gentle motion around home allowed. I can pick her up, properly and carefully, but can't yet bathe Claire as we don't want her rolling around and running actively as dogs often do to dry off. A harness is preferred over a collar by Dr. Voulgaris, and I'm going to have to continue to find a way to do Claire's nails without flipping her over on her back. Chance can sleep or stay in the same crate with Claire at this point as long as there is no roughhousing going on.

One of the first things I did after our visit was to make calls to vet techs & pet walkers we know to see who would be able to assist us in doing Claire's therapy at home, at least some of the time. I need one person to hold Claire on her side while another does the physical manipulations. It looks like I will be paying for help three times a week for about $50 per week; just one more factor adding to the cost of Claire's ongoing care.

Claire's CARE PT Exercises for Home

These are the therapy exercises recommended for Claire to do at home. Each dog is individual. Please consult a professional before beginning any therapy with your dog. I am not a veterinarian and the obvious risk for damage without proper knowledge is huge. The order is arbitrary but for my own ease I tried to group them to have as few changes in position for Claire as possible. I duplicated some exercises that said "repeat each side" and listed them again so that I wouldn't forget to do them when I flipped Claire over. Click on any of the images to enlarge to a readable size.

(dog lies on tummy first)

(dog lies on one side to work on dog's left side)

(flip dog to lie on other side to work with dog's right side)

(pick up dog)

(standing dog exercises)

A Very Cool Book about A Very Cool Dog

I saw a wonderful book at CARE yesterday: Murphy Meets the Treadmill, by author Harriet Ziefert.

From the description off PaperbackSwap:

Murphy is a simple dog with simple pleasures. He's happy just to lie on the porch and watch the people go by, especially if they have treats for him to eat! All those treats add up, though, and even Murphy has to admit that maybe he's not such a fine example of his breed after all. But what's a dog to do? Cheryl says he has to diet, and that's just the beginning. One day a delivery van arrives with a strange machine. Murphy puts up quite a fight, but Cheryl is determined to get him trim and fit. Soon, the neighbors can't stop talking about Murphy's new activity. Who says you can't teach an old dog new tricks! Readers will delight in the familiar battle of wills between pet and owner, hilariously portrayed through Harriet Ziefert's witty text and Emily Bolam's warm, expressive illustrations.