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Case Study -- The Little Yorkie That Could
Found alone, mortally-wounded, and unable to move in a Good Samaritan's driveway, this nearly lifeless little purebred Yorkshire terrier did not seem to have a fighting chance of survival, not to mention, ever walking again. This approximately 2 year old, 4 pound female was rushed into the welcoming arms of the staff at Framingham Animal Hospital where she was surrendered for care. Although her rightful owner was never found, the staff agreed to provide the critical care necessary to ensure her survival. Her exam revealed several puncture wounds, likely the victim of a coyote who gripped her with its teeth and shook her, resulting in neurological damage to her spinal cord and possibly brain. Miraculously, she had no orthopedic injuries. As she clinged to life and her wounds healed, she began to eat and drink small amounts through droppers. After a few days of treatment when she was stabilized medically, I was contacted to initiate physical therapy (PT) with the hopes of getting this fragile little Yorkie walking again.
When I saw her for the first time, I was struck by how tiny and frail she seemed, but she was alert and her eyes were bright. She could only hold her head up for brief periods and was unable to lie sternally without support. She had good motion and flexibility in her limbs. The neurological reflexes, such as the ability to sense pain, indicated that a positive outcome was possible. However, she had severe deficits of conscious proprioception, or the ability to sense where her limbs were in space, which prevented her from being able to bear any weight on her legs, let alone take steps. In fact, she also lacked certain protective reflexes normally present to keep the dog from harm. She exhibited high tone, or a neurologically based stiffness, in her left front limb such that it stuck straight out to the side like a prop with no functional use.
Undaunted and actually encouraged by my exam, I commenced a PT program consisting of massage to decrease discomfort and promote circulation, stimulation to provide various types of sensory input to her body and limbs, passive range of motion and stretching to maintain her joint movement and tissue flexibility while she was not able to move on her own, neurofacilitation techniques such as symmetrical positioning and developmental sequencing, proprioceptive and balance activities, starting with head and trunk control on a giant therapy ball, weight bearing and patterned walking with maximum assistance and slings, and hydrotherapy. With an extra-extra-small life vest we were able to put this little Yorkie in a tub of water for "swimming."
After just one session, she had markedly less discomfort with handling, much better head and trunk control, and less abnormal tone in the left front limb. After only a few physical therapy sessions, she could lie normally without support and move about some in her cage, even pulling herself up for attention. Her protective responses had also started to return in her right front leg. And yes, she started kicking her legs in the water!! She was able to stand and take a few steps with her hind limbs with the support and buoyancy offered by the water, but still could not stand or take steps on land. Although this may not seem like much, she was making remarkable progress. Everyday, the staff, each of whom contributed to her recovery, noted small improvements in her function.
Fast forward to the present, five weeks after her arrival at the hospital: She has been named "Pebbles" by the staff and was adopted by one of the talented nurses, Matthew. Pebbles can roll both directions, sit up, get into a standing position, and take steps all by herself. In fact, Matt reports that she runs to chase his cats in the yard, although she topples over occasionally!! Her right front leg is essentially normal, her rear limbs splay out some, and the left front limb is still problematic, but improving regarding the abnormal stiffness. All reflexes have improved dramatically as well. Her new owner was given a comprehensive home program to help Pebbles continue improving so she may have the highest quality of life possible. She loves to be held and spoiling her is the first directive in her care!
With a tincture of time, we are all hopeful that she will continue to make steady progress and walk better and better. It can take 6-12 months for full potential to be reached in neurological cases. The nervous system has tremendous resiliency, but at the same time, nerve tissue is the slowest to regenerate. So only time will tell, but the take-home message is to not give up on these types of cases too soon. Even the gravest injuries can have a positive outcome!
This is just one example of the type of injury that physical therapy can benefit. I also treat a variety of orthopedic conditions, including post-operative cranial cruciate ligament reconstruction rehabilitation, and other neurological diseases. Additionally, I provide wellness consultations for prevention of injury and maintenance of function. Please go to my website: www.CranstonPetRehabilitation.com for more information about physical therapy for small animals and my business. I would love to be of service to you and your pet!
Posted by Chris Cranston, MPT, CCRP
Physical Therapist & Owner
Certified Canine Rehabilitation Practitioner
CRANSTONPET REHABILITATION
P.O. Box 541133
Waltham, MA 02454-1133
Ph:339.222.9321
www.CranstonPetRehabilitation.com
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