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.

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)

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 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.

CARE Evaluation Questions

I made a list of questions to ask the vet when Claire is evaluated at CARE for possible physical therapy. I posted these on facebook to see if anyone had anything to add, but didn't receive any responses. The Dodgerslist site has several vet question lists which I also reviewed but none that specifically address rehab. In completely random order, here they are:

What is your case load per month treating IVDD and what is your success rate/complications rate?
Do you recommend acupuncture, chiropractic or other alternative treatments?
What do you think of laser therapy with a Class IV laser?
Do you recommend the use of supplements? Which ones? How much?
When do you recommend that the dog starts physical therapy and what kind?
What exercises will you do in-clinic?
What exercises can you teach me to do with Claire at home? How often and how long should she do these exercises?
What will be the signs that Claire has overdone therapy? What should I do if I see her acting this way?
What about wearing the brace?
Can you tell me the specific vertebra that has herniated? Which are the two that the neuro thought were bulging?
Can Chance be with Claire in the same crate?
Can Claire have a bath? How should I dry her?
What's the best way to clip her nails?
What about non-anesthetic teeth cleaning?
Do you know what LDA is? Do you recommend that for Claire?
Can I split her therapy program into two parts, before and after the Laser Disc Ablation?
How do you limit jumping?
How best to teach Claire to only use the ramp to get up/down from couch?
Do you recommend harness over a collar?
What are your concerns about Claire's gait?
What are your concerns about Claire's squat?
Claire is not stretching her back legs as far as she used to. How can I encourage that?
Should we bring a life vest for any water therapy? Do we need to bring treats with us?
Do I need to elevate her food dishes? Talk about the way she eats like she's starving.
Can I pick her up as much as I want?

Can I pay in installments?
I'm low income. Do you have any assistance programs?
What do I need to do to set up donations coming in via phone?

A Weekly Update

(Claire Sept 2006, within 2 weeks of adopting her)

Things here are settling into a routine somewhat as we wait out Claire's crate rest till the end of the month. I've formulated a basic plan that looks like physical therapy at CARE in September, and if Claire's a candidate, Laser Disc Ablation at OSU in Stillwater, Oklahoma in October. I'm still doing a bit more research on the side effects of LDA.

We got a mesh harness like this for Claire that we tried out over our weekend trip to see my parents. I had her wear it 24-7 to eliminate the movements of putting it off and on, and that turned out to be a mistake. I haven't been looking at her underside much as I shouldn't be flipping her over right now because of the spinal manipulation. But when I did finally have the chance, I noticed she'd given herself light rugburns in her armpits from the harness! They still haven't completely faded. She's not getting walked right now anyway, but a leash is recommended when taking IVDD pups out for potty breaks to limit their movement, and my parents have a huge yard, so I thought it appropriate. My yard is only about five steps square, so I haven't been using one here. So we have a couple weeks to work out another solution.

I bought a retractable ramp for our car off of craigslist. Used, it cost me only $40 cash. I found it online here new for $99 plus $20 shipping! I think the nonskid surface it came with is pretty abrasive, so I want to get a piece of carpeting or a runner of some kind for it. Hoping I can find that at the dollar store. I still need to work out a ramp situation for the couch and bed in our house, but again, I still have a couple weeks to pull it all together before she's off crate rest.

I've made some changes to Claire's diet. I've started covering her dry kibble in water to get more liquids into her, and she still gobbles it up--especially when I mix in a generous tablespoon of plain canned pumpkin to help her digestion. Claire's always had control of her bowels, but I do think it's been taking her longer or not as easy. She's off all pain meds so this should have gone away, but I know her squat isn't as deep so I'm wondering if that has something to do with it. She's up to three Dismusyme tablets a day. Occasionally I'm throwing in a 1/4 tsp of fish oil too.

Claire's getting more impatient with the crate, which I'm thrilled to see! Her personality is slowly coming back. I'm keeping the line though, and she does generally listen to commands when I ask her to "Go Crate" after a potty or meal break. Yesterday she scratched the ground after a poop for the first time in a long time! You have to be the parent of a disabled pet to know how much joy can come from a dog's potty habits. The day before that she was chasing her tail, something she did often when I first got her. Looking back, was that neropathic pain?

I've been checking back with the donation cans at Pet Haven, C&C Pets, & Zoom Room Culver. Claire's fund is now at $2075! Thanks again to all who have helped support her. I'm still leaving the money in her savings account until she goes to physical therapy or surgery, and meanwhile covering the cost of acupuncture, laser therapy, vet visits, and meds myself. These funds allow me to make decisions in Claire's care based on her best interest, rather than my financial situation. Thank you from the bottom of my heart for making that choice possible. Please keep her in mind as this saga is ongoing. CARE has said they will accept donations towards Claire's physical therapy as well, once we're a patient there.

MRI Films, Acupuncture, Another Collection Jar, and Insurance Claim Forms

(Claire & Chance at puppy school, Jan. 2011)

This morning I followed up on the ChipIn. Though folks have contributed, it's still reading $0 because my PayPal account is not verified and thus not linked up to the ChipIn. Unfortunately it looks like I'll be waiting a couple of days to verify the PayPal account--right now, the ball's in their court. The good news is that once that step is complete, the transfer of funds is easy.

I picked up Claire's MRI films and records from Dr. Gorgi today before picking up Claire and heading to yet another new vet--we met Dr. Jackie Grey at Limehouse Vet in Toluca Lake this afternoon, and Claire had her first ever acupuncture treatment. She was quite excited to be out of the house after being trapped in her boring crate for the last several weeks! Though she seemed to like Dr. Grey just fine, she definitely didn't like the needles being stuck in her back. The idea with the acupuncture was to have the needles in for about fifteen minutes. The vet had to take her out of the room to the back once the needles were in because she was so wiggly around me that the needles were falling out. We sat around the waiting room for quite a while after the appointment too waiting for medications and an insurance claim form. It was nice to get a feel for the vet by watching other clients come and go, and Claire got a bit more adjusted to the noises, sites, and smells.

I was so nervous about the appointment that it didn't occur to me to bring a camera and take a photo. We have our second treatment this Thursday, so I'll take one then. I had no idea what the needles would look like, where they would be placed on an animal, or how many of them there would be. I'm sure there are other people who wouldn't know what to expect either, so I'll try to show it.

Dr. Grey specializes in homeopathic medicine, and she put Claire on two new meds: an antioxidant enzyme pill called Dismuzyme and an anti-inflammatory liquid called Traumeel. I feel like I have at least five things to research each day of this process; tonight I'm looking up the meds.

After taking Claire home from the vet, I took a collection jar to our favorite neighborhood pet store, Pet Haven in Burbank. Chance and Claire go there monthly for non-anesthetic dental cleaning, and we order our pet food through them. They're generously doing what they can for Claire.

Oh, and my homework tonight is filling out insurance claim forms for all that's happened this month....that will pretty much vacate the cap on the category.

Monday--Banks and Blogs

(Claire sleeping with a smile April 2011)

I went to sleep last night knowing Monday would be a better day, and woke up to find $120 had been deposited to Claire's ChipIn fund! Unfortunately, the ChipIn still says $0 donated, and I think it's because I've been unable to claim the funds so far. The final step in the ChipIn setup requires a Paypal account linked to a bank account. Since I have paypal for my Etsy shop, I kept getting error messages when trying to set up something for Claire. So this morning started with another trip to the bank, to close the account I'd just opened on Friday (that was linked to my own) and establish an entirely separate one that I could link up to Paypal. I also deposited everything raised yesterday at Nuts for Mutts, bringing the total raised so far (including the ChipIn funds) to $616.86.

We had a follow-up phone call this afternoon with Dr. Gorgi, Claire's surgeon. He didn't have much to add but did say he'll give us 20% off on the surgery when we've met our goal.

After researching a few more, I chose a therapist to use for Claire--at least to start. She has an appointment tomorrow (Tues 6/28) afternoon with Dr. Jackie Grey at Limehouse Vetrinary in Toluca Lake. It's close to the house, and she was recommended by another dog owner in the neighborhood. Claire's surgeon, Dr. Gorgi, said he's had a couple clients go to her in the past with positive results. But he also spoke strongly against chiropractic care for Claire's condition, recommending accupuncture instead. I ordered Claire's records and will pick up a copy of the MRI images before seeing the new vet. I feel like I'm getting a second opinion tomorrow and can only judge as I go--at this moment, I'm not convinced by anyone.

I ran out of pain meds for Claire over the weekend, when all pharmacies were closed. I finally found a compounding pharmacy in my neighborhood today, but filled another prescription that did not need to be compounded at Costco, for fear that the compounding place would be much more expensive. When I compared their pricing, they were about 33% more than Costco, so I was glad I'd split them up, though it took nearly two hours to get both errands done. But to their credit, the compounding pharmacy told me in future they would match the Costco pricing for me to save me an additional trip. So for anyone in a similar position, it's worth it to do your research--then ask to price match. The worst that can happen is being turned down.

The majority of the day was all about Claire's blog. I want a site independent of Facebook for those who aren't on it. I'll use the blog to encourage donations and allow donors to track Claire's progress and recovery, as a journal to help me track whom I have approached and the responses, and as a resource for others who face difficulties (monetary or otherwise) in caring for their pet's medical conditions. I'm hoping the sidebars and resources will be useful to others long after we've been through this process and that some good will come of our story. Not to mention, on a blog we can use affiliate opportunities to raise funds through click-throughs and online purchasing, as well as administer raffles and other giveaways.

While I was blogging, a kind friend helped me begin to pull together my financials. I should be current by the end of the week, which will enable me to apply to more private foundations.

Goodnight kisses from Claire~

A Busy Day on the Claire Front

Friday morning I started by taking the money donated by my co-workers to the bank, and establishing a savings account linked to my own specifically for Claire's surgery.

I also called around to several therapists/vets that I'd been recommended to by my own vets and by some other dog owners in my neighborhood, and spent some time on yelp reading reviews there as well.

I picked up dog food (still have to eat, despite it all) and poured my story out to our friendly pet store owner. She sent me home with a flyer for Nuts for Mutts and suggested placing a collection jar at the register, so that got me thinking about a design for those.

At home, I poured through photos, made a collage large enough to use on a poster, and ordered several printed as 4x6s to use on jars. I sent them online to be printed at a local photo shop, and picked them up late in the evening, along with a tri-fold posterboard and some blank mailing label stickers. I used the stickers to make an explanatory blurb about Claire that could be pasted to jars. Throughout this post are the pictures I used for the posters and jars.

I was still doing constant networking over the phone, and research on the internet. Friday evening I completed a Care Credit application online and was approved for a low cost loan. But as a freelancer, I hate to use credit when I have no assurance of paying it back in a timely fashion. And while Care Credit is a great deal if paid on time, like most credit cards, the interest rate balloons if even one payment is late.

On the down side, we got a voicemail late in the afternoon from the Sam Simon Foundation. Unfortunately, I missed the call, but the staffer left a kind and lengthy message explaining that they couldn't help because Claire's surgery was too involved to be done in a mobile clinic, since she'd need to stay overnight at the vets for several days following. The caller said her dog had had the same surgery, so I look forward to connecting with her soon just to hear her story. She stressed that Claire's crate rest in the meanwhile should be absolute, with no picking her up, steps, or jumping at all. She put fear into me and made me take crate rest much more seriously. I took the denial hard, mostly because it had seemed such a great fit with my entertainment background. But the fundraising goes on, and Claire and I won't give up....