Blue

Physiotherapist report – Blue R 26^(th) August 2020 Subjective: Blue has had a recent spinal trauma and has since had no motor capacity in bilateral hindlimbs. Owners are dedicated and able to carry out some exercises to aid Blue. Blue is crated and allowed onto the kitchen floor (tiled) advised to use carpet off-cuts to prevent slips and aid traction to Blues hind-limbs when positioning. Blue is able to be toileted out in a patio area – hind-limb sling given to aid with this. Currently Owners are still carrying out massage, proprioceptive tasks and ROM/postural set exercises daily to aid with nerve input and mental stimulation while maintaining joint fluid quality and muscle tone. Objective: Significant trigger points and spasming bilaterally over the shoulders as expected due to strain from locomoting with forelimbs. This needs monitoring. Bilateral spasming down epaxials musculature, approached with extreme caution and gentle massage was used and tolerated on the cranial portions. T12-L3 palpable region where temperature changes. Hypotonicity bilateral hind-limbs spasming in biceps femoris of the RH. Range of motion: Range of motion is good in all limbs no joint restrictions palpated. Action: LASER, massage and PMFT used alongside passive range of motion and postural sets. - Monitor weight - Proprioceptive tasks – sponges, paper, brushes to be used all over Blue for nervous input - Assisted toileting – use command words sit and stand with placement - Arrange Blues limbs to be in a natural posture where possible to aid bloodflow and prevent spasms - Massage and grooming to be done – mental stimulation and bloodflow Becky Black BSc(Hons) AdvCertVPhys ClinEd(AccMdx) RCH MIRVAP Blue - Weekly Plan Aims: - Maintain comfort and hygiene levels - Give stimuli to affected limbs - Maintain mental stimulation and reduce stress Toileting With toileting, we are aiming to be able to reduce the time Blue is lying in any wet spots and reduce the chances of Blue developing a urinary tract infection from withholding urine. It may be a good idea to have some non scented wipes/wet cloth to wipe over Blue after toileting to protect against any infections developing. Moving As you are doing so well, continue using the towel to support Blues hindlegs and maintain a straighter spinal posture. To help you may place carpet or runners on your path where you need to move Blue to give him some added traction on his legs and reduce stress. Postural Sets- When moving Blue aim to move him into “normal” lying posture. This can be flat out on his side, on in a sphinx position with the hindlimbs tucked under and forelimbs straight out. This then makes it easier to move Blue around into a sit or stand. (See end of Doc) Grooming/Washing Mentally spending some time giving Blue a sponge bath will aid hygiene and mentally allow Blue to enjoy spending time with you, this also allows for checking of the paws or body for pressure sores which may mean Blue needs to be moved or turned more regularly. A good firm vigorous brush will stimulate bloodflow and in turn decrease pain and stimulate the hair/skin/muscles. Mental stimulation Using mashed banana or treats in cone/kong toys or puzzle feeders can help Blue mentally have a challenge and keep the mind active while washing or just to keep Blue occupied while you do house work/look after baby. Exercises/Manual work – Help function Range of Motion – Increase Blood Flow Here is a link to a range of motion exercise, this needs to be done for as long as you can on each back leg (At least 20x cycles a day). This gets blood flow to the hindlegs and ensures the muscles are maintained, this also circulates joint fluid and keeps the joints healthy. https://www.youtube.com/watch?v=hHXdqy__vJo (1.50-2.50 is the only bit we need) Massage Starting from the shoulders firmly press and massage in a slow rhythm towards the neck, stroke firmly along the back counting 1 and ,2 and ,1 and ,2 . This will relax these muscles that Blue is over using to compensate. The hindlimbs we can using 2 fingers, tap briskly and lightly over the legs, and use very fast brisk stokes to “wake” up the nerves. Texture work Use several textures against Blues pads to give some stimulation, this can also be done alongside the carpet runners to create paths (door mats, bathmats) provide different sensations for Blue to walk over. Other things to use could be: - Nail brush bristles - Cloths - Sponges - Newspaper balls Toe pinches/tickles This elicits muscle contraction and keeps the tone of the muscles Aim for a few each day where manageable. It can be done by a tickle or a slight pinch of the foot, this may occur as you do the texture work. [] From lying flat, treats can be used to encourage Blue around and then his legs can be positioned as a sphinx facing forwards. [] From Sphinx position, either using the command “sit” or raising the head with a treat, a sit position is reached (ensure not to try on a slippery surface)