Mac

Veterinary Physiotherapy Report +-----------+----------+------------+-----------+-----------+------------+ | Treatment | 5.8.21 | Date of | 22.07.21 | Treatment | 8 | | Date: | | last | | Number: | | | | | Treatment: | | | | +:=========:+:========:+:==========:+:=========:+:=========:+:==========:+ | Animal | Mac | Age: | 11yrs | Breed: | Crossbreed | | Name: | | | | | | | | | | 17.4.2010 | | | +-----------+----------+------------+-----------+-----------+------------+ +------------------+---------------------------------------------------+ | Veterinary | Fran Cummins - Highfield | | Surgeon: | | +:================:+:==================================================+ | Diagnosis on | Suspected lumbar disc problem | | Referral: | | | | OA in hips & spine | +------------------+---------------------------------------------------+ +--------------------+---------------------------------------------------+ | Medical History: | 2018-soft tissue sarcoma removed with margins RH | | | medial tibia | | | | | | 2019-cytology on 3 masses – all lipomas | | | | | | 15.3.21 – struggling HL – painful L spine, dec | | | hip ext, no neuro deficits | | | | | | 30.3.21- Rads- mild HD bilaterally, L carpal mild | | | OA, Lumbar disc narrowing & poss calcification | | | | | | 6.5.21-Pride referral-No diagnostics as had shown | | | good improvement by time of appt – telephone | | | recheck in 1 mth to poss decrease gaba dose if | | | doing well | +====================+===================================================+ | Drug History: | Previous Galliprant but now on Gabapentin only | | | Paracetamol as nec but not needing generally | | | | | | No Gabapentin due to stomach flare-ups | +--------------------+---------------------------------------------------+ | Contraindications: | Spinal diagnosis not confirmed and previous | | | Sarcoma removal so avoid electrotherapies as | | | precaution | +--------------------+---------------------------------------------------+ | Additional Notes: | Exercise Routine: 30 mins Am and 20-30mins PM at | | | steady pace as likes to sniff- OR stamina seeming | | | to improve recently. | | | | | | Home Environment: Non slip flooring underfoot. | | | Does use stairs and copes well going up but OR | | | steady going down ?stiffness through FL | | | | | | Owned since 2yr old from rescue -always had | | | colitis – reactive to beef and fatty foods | +--------------------+---------------------------------------------------+ Assessment Stance Observations: Neutral spinal posture Good HL BOS Good weightbearing HL, mild cranial weightshift present Movement Observations: Mildly stilted HL movement with low flight arc bilaterally OR can scuff occ but not noted during session Slight stiffness FL today L>R Good sit posture – much improved Quad control Subjective: Doing better today- recent tummy upset again, not as bad and didn’t need antibiotics but still weakened his HL and increased wobbliness and sinking at stance. Had to cancel hydro this week as a result. Physio in place with Becky Black while owner away- weekly sessions as no hydro available. Objective: Palpation: Mild hypertonicity through cervical musculature R>L Mild hypertonicity through prescapular muscles L myofascial restrictions Lats/Traps L with TP remaining caudal border scapula L TP R thoracic Traps Knuckling reflexes NAD bilateral HL Withdrawal reflexes NAD bilateral HL No response with pressure to mid lumbar spinous processes (step in vertebral column T13-L1/L2 region) Improved tone through hamstrings and quads L>R PROM: RF–good movement through shoulder elbow and carpus. Restricted scaplua LF-good movement through carpus and elbow, shoulder extension complete today RH- good movement through stifle and hock, hip ROM – hesitation towards end range extension LH-good movement through stifle and hock, hip ROM complete Restricted in Left lateral thoracic flexion Treatment Electrotherapies: None used due to contraindications Manual Therapies: Soft tissue massage generally over cervical, thoracic sling regions and epaxial muscles bilaterally Scapular glides CrCa and DV planes bilaterally MFR through Lats/Traps bilaterally FL protraction and retraction stretches x 3 reps each FL following soft tissue work Hip extension stretches x 3 reps each HL Active Exercise: Sit to stands: much better today, pushing up well again Paw gives in sit – abducts bilaterally in paw give- abduction decreasing with reps Home Exercise Programme - Heat therapy (warm water bottle or wheat bag with a covering on) apply over areas of increased muscle tone for 5-10 minutes before massage if tolerated. - Massage. Use small circular and long sweeping movements with a comfortable pressure over the areas shown. Apply for 10-15mins as tolerated once daily - Sit to stand. Ask Mac to sit and then push up into a stand position. Ensure slow controlled movements wherever possible – perform up to 8 reps once daily, - Caudal weightshift in stance. Ensure a good stance posture, place your hand on the front of his chest and apply gentle pressure until you see the hindlimb muscles engage, hold for a second and then release. Repeat 5-6 times up to twice daily - Ice therapy. Use an ice pack/frozen peas wrapped in a towel and place over the lower back (where he’s sore) apply for 5 mins after each walk as tolerated. If he doesn’t like it don’t upset him with it though. - Spinal flexion exercise -either use a treat to take his head between his front legs or whilst drying with a towel is fine. Aim to get some lift up through the back -only as far as comfortable -start with 2/3 reps once daily - Paw gives – up to 8 reps each paw once daily